骨软骨瘤。骨科学研究

Humberto Ferreira Arquez
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摘要

背景:骨软骨瘤是最常见的骨肿瘤,约占骨骼良性病变的三分之一,是由骨髓和皮质骨组成的宽(无梗)或窄(有梗)的骨骼突出。虽然它是良性的,但其生物学行为仍有恶性的可能。由骨软骨瘤引起的软骨肉瘤已被认识多年。骨软骨瘤可发生于任何由软骨构成的骨骼,尤其见于四肢的长骨,主要发生在膝盖周围。事实上,下肢的肿瘤风险似乎高于上肢的前两个位置:股骨远端和胫骨近端,然而,肱骨近端是单发骨软骨瘤的第三位,而腓骨近端是多发骨软骨瘤的第三位。方法与发现:本研究采用2013-2016年西班牙潘普洛纳大学形态学实验室医学本科生常规解剖课,共采集20具骨骸和18具尸体,男16具,女2具,年龄不同。只有一个样本被发现存在骨软骨瘤。骨量测量为7 x 3.5 x 1.5 cm,附着于股骨中间三分之一的后外侧。结论:骨软骨瘤一般无症状或偶然发现,但根据发生部位不同,可引起不同的症状,如局部肿胀、骨畸形、骨折、滑囊形成、关节炎和相邻肌腱撞击、血管或神经损伤、脱位等。对大型骨软骨瘤进行正确治疗和随访,以避免并发症,如对邻近神经血管结构的进一步损害,以及潜在的恶性变性。本研究描述一个罕见的位置从骨软骨瘤股骨骨干。
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Osteochondroma. An Osteological Study
Background: Osteochondroma is the most common tumor of bone, accounting for approximately one third of benign lesions in the skeleton is a broad (sessile) or narrow (pedunculated) skeletal protrusion comprised of marrow and cortical bone. Although it is benign, its biological behavior still has a malignant potential. Chondrosarcoma arising in osteochondroma has been recognized for many years. Osteochondromas might occur on any bone preformed in cartilage, they were especially seen on the long bones of the extremities, predominantly around the knee. In fact, the lower limb seemed to be at a higher risk of the tumor than the upper limb on the top two locations: distal part of the femur and proximal part of the tibia, however, the proximal humerus ranked the third place for solitary osteochondroma while the proximal fibula for multiples osteochondromas. Methods and Findings: A total of 20 skeletons and 18 cadavers of both sex, 16 males and 2 females, with different age groups were used, this study was carried out by routine dissection classes for undergraduate medical student´s in the Morphology Laboratory of the University of Pamplona during the years 2013-2016. In only one sample was found the presence of osteochondroma. The measurement of the osseous mass was of 7 x 3.5 x 1.5 cm, attached to the posterolateral aspect of the middle third of the femur. Conclusions: Osteochondroma is generally asymptomatic or discovered accidentally, but it can cause different symptoms depending on site of occurrence local swelling, bony deformities, fracture, bursa formation, arthritis and impingement on adjacent tendons, vascular or neurologic compromise, and dislocation The importance of correct treatment and follow-up of large osteochondromas to avoid complications such as further damage to neighboring neurovascular structures, and potential malignant degeneration. The present study describe a rare location from an osteochondroma in the femur diaphysis.
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