骨纤维异常增殖症自发恶变15例分析  

Spontancous Malignant Degeneration of Fibrous Dysplasia(Analysis of 15 Cases)

作　　者：徐德永[1] 宫尚君[1] 于守连 张永吉[1] 贾天伦 王世平 刘继联 刘健[1] 

机构地区：[1]青岛医学院附属医院放射科,山东省招远市人民医院,新疆乌鲁木齐市中医院,中国人民解放军第一四六医院,山东省莱西市人民医院,山东省新汶矿务局中心医院,中国人民解放军第一三五医院

出　　处：《中华放射学杂志》1994年第1期36-39,共4页Chinese Journal of Radiology

摘　　要：报告１５例骨纤维异常增殖症（简称骨纤）自发恶变，其中恶变为骨肉瘤８例，纤维肉瘤５例和软骨肉瘤２例。１５例均长期患有骨纤，均未接受过放射治疗。本组恶变者中，多骨型骨纤１１例，单骨型４例。恶变患者的主要临床症状是病变区疼痛和肿胀，而后则出现硬性肿块。恶变的Ｘ线表现为：在原骨纤病变区域内，出现虫噬样或囊状溶骨性破坏，骨纤病变边缘变模糊或消失，皮质破坏并逐渐出现软组织肿块。恶变为骨肉瘤者，肿瘤区内常有不同形态的痛骨；软骨肉瘤则可见环状或斑片状钙化；纤维肉瘤则表现为单纯溶骨性破坏，软组织肿块呈中等密度。Fifteen patients with spontaneous malignant degeneration of fibrous dysplasia were reported including 8 osteosarcoma,5 fibrosarcoma and 2 chondrosarcoma. In all 15 cases,the patients were known to have longstanding fibrous dysplasia, but no radiation therapy was ever received.11 pa-tients had polyostotic fibrous dysplasia and 4 monostotic lesion. Clinically,pain,swelling, and later fol-lowed by the appearance of a bony mass are the main clinical findings. The radiographic features of sarcomatous degeneration in fibrous dysplasia include moth-eaten or cystic area of osteolysis, cortical destruction,and soft tissue mass in the vicinity ofdisrupted cortex. Various neoplastic bone in the bone lesion and soft tissue mass is regarded as highly suspicious of osteosarcomatous transformation, while ring-like and spotty calcifications in the tumor matrix are indicative of chondrosarcoma. Fibrosarcoma usually shows simply osteolytic destruction. These findings may be used as a clue for differentiating va-rious kinds of malignant degeneration.

关 键 词：骨纤维增生 恶变 自发性 病例分析 

分 类 号：R738.1[医药卫生—肿瘤]