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目的 :评价髓内高分化骨肉瘤的临床特点及组织学特征。方法 :通过对与该肿瘤有关的文献回顾 ,归纳总结髓内高分化骨肉瘤的临床、影像和病理学特点 ,以及诊断、治疗要点和患者预后。结果 :其发病年龄较典型骨肉瘤稍大 ,3 0～ 40岁多见 ;病损多位于长骨干骺端 ,特别是股骨和胫骨 ;组织学没有特征性。由于认识不足 ,5 0 %的患者于初诊时误诊为纤维结构不良或动脉瘤样骨囊肿等良性病损。骨皮质破坏和软组织肿块是重要的鉴别诊断线索。广泛切除可获很好的疗效。结论 :对该病的诊断 ,强调组织病理学与影像学的互参 ;不恰当的手术将导致肿瘤的复发和转移。
Objective: To evaluate the clinical features and histological features of highly differentiated osteosarcoma in the intramedullary. Methods :To review the clinical, imaging and pathological features of highly differentiated intramedullary osteosarcoma, as well as the diagnosis, treatment points and prognosis of patients by reviewing the literature related to this tumor. Results: The age of onset was slightly larger than that of typical osteosarcoma, and it was more common in 30-40 years old. The lesions were mostly in the metaphysis of the long bones, especially the femur and tibia. There was no characteristic histology. Due to lack of understanding, 50% of patients were misdiagnosed as benign lesions such as poor fibrous structure or aneurysmal bone cysts at the time of initial diagnosis. Cortical destruction and soft tissue masses are important differential diagnostic clues. Extensive resection can get very good results. Conclusion: The diagnosis of this disease emphasizes the cross-referencing between histopathology and imaging. Inappropriate surgery will lead to tumor recurrence and metastasis.