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骨原发性平滑肌肉瘤罕见,确诊难度较大,本院病理诊断证实2例长骨平滑肌肉瘤,结合文献复习,总结分析如下: 例1男性,38岁。以右大腿阵发性肿痛伴跛行1年余, 加重2个月入院。体查:右股骨下段压痛、叩痛明显,局部肤温基本正常。X线摄片示:右股骨踝上囊样改变,考虑炎症或囊肿(图1)。血尿便常规检查、肝肾功能、血沉及碱性磷酸酶均未见异常。行病灶清除+植骨术,术中见股骨下段病变物呈果冻样。病理回报:恶性肿瘤,结合进一步免疫组化及远程病理会诊结果,诊断为平滑肌肉瘤。 ECT检查全身无肿瘤转移灶。术后行放、化疗。
Bone primary leiomyosarcoma rare, difficult diagnosis, pathological diagnosis confirmed 2 cases of long bones leiomyosarcoma, combined with the literature review, summarized as follows: Example 1 male, 38 years old. Paroxysmal parietal swollen right thigh with claudication more than 1 year, increased 2 months admission. Physical examination: the right femur lower tenderness, percussion pain was obvious, the local skin temperature was normal. X-ray showed: the right femoral ankle sac like changes, consider inflammation or cysts (Figure 1). Hematuria routine examination, liver and kidney function, ESR and alkaline phosphatase were normal. Excision of the lesion + bone graft, intraoperative see femoral lesion was jelly-like. Pathological findings: Malignant tumors, combined with further immunohistochemistry and remote pathological consultation results, the diagnosis of leiomyosarcoma. ECT examination of the whole body without tumor metastasis. After surgery, chemotherapy.