胸壁 肺 肝及皮下组织多发骨化性肿块  

Ossifying Tumor of the Chest Wall,Lung,Liver and Subcutaneous Tissue: A Case Study

作　　者：谢红旗[1] 赵年贵[1] 柯明耀[1] 林亚乐[1] 徐朝斌[2] 

机构地区：[1]厦门市第二医院呼吸中心,福建省厦门市361021 [2]厦门市第二医院病理科,福建省厦门市361021

出　　处：《中国肿瘤临床》2009年第19期1128-1131,共4页Chinese Journal of Clinical Oncology

摘　　要：患者咳嗽、胸痛20天,发热气促5天住院,12年前左手拇指疼痛性结节,病理活检示"骨旁骨肉瘤"。多次手术切除未能治愈。2年后行左上肢前臂下1/3截肢术后治愈。2008年9月12日入院胸部、腹部CT平扫示右侧胸腔大量积液,胸壁、肺、肠壁、皮下组织、肝多发骨化性肿块,电子胸腔镜示右侧胸腔大量血性脓水,右肺不张,胸膜广泛粘连,壁层胸膜大小不等的结节及肿块。病理活检为间叶组织来源的恶性肿瘤,结合组织免疫诊断为皮质旁骨肉瘤。皮质旁骨肉瘤为一种低度恶性肿瘤,原发肿瘤手术切除后治愈,12年后复发少见,全身多发骨化肿块,易与淋巴瘤、结核混淆,复发原因可能与去分化为高度恶性肿瘤有关,去分化皮质旁骨肉瘤顸后差,化疗无效。The patient was admitted to the hospital with chest pain, cough, fever and shortness of breaththat had lasted 5 days. Twelve years previously, the patient had a painful nodule in his left hand that was diagnosedthrough a biopsy as parosteal osteosarcoma. After several surgeries, the patient was not cured. Twoyears later, the patient underwent amputation of 1/3 of the left forearm. At that time, a CT scan of the chestand abdomen showed right pleural effusion and ossifying tumor in the chest wall, lung, intestinal wall, subcutaneoustissue, and liver. Electron microscopy showed bloody pleural effusion, right lung atelectasis, extensivepleural adhesion, and parietal pleural nodules of varied sizes and masses. A biopsy was performed and afterthe sample was evaluated as a possible tissue-derived mesenchymal malignant tumor and immunohistochemistrywas performed, the patient was diagnosed with parosteal osteosarcoma. Parosteal osteosarcoma is alow-grade malignancy. The primary tumor can be surgically resected and rarely recurs within 12 years aftersurgery. Ossification of a mass of body fat is easily confused with lymphoma and tuberculosis. Recurrence ofossifying tumor may be related to the multi-polarization of the high malignancy. Ossifying tumor does not respondto chemotherapy and its prognosis is poor.

关 键 词：皮质旁骨肉瘤 骨化性肿块 去分化 

分 类 号：R738.1[医药卫生—肿瘤]