单中心170例足踝部肿瘤及瘤样病变临床分析  

Tumors and tumor-like lesions of the foot and ankle： 170 cases treated in a tertiary referral center

作　　者：栗向东[1] 张宇[2] 王臻[1] 郭征[1] 

机构地区：[1]第四军医大学西京医院骨肿瘤科,西安701132 [2]兰州军区总医院骨科

出　　处：《中华骨科杂志》2012年第11期1066-1072,共7页Chinese Journal of Orthopaedics

摘　　要：目的探讨足踝部肿瘤和瘤样病变的流行病学特点、临床表现以及恶性肿瘤的预后。方法通过对25年间170例足踝部肿瘤及瘤样病变的临床资料进行回顾性分析，并对恶性肿瘤进行随访，分析其年龄和性别分布、临床表现、肿瘤组织类型、解剖学部位分布、肿瘤大小与良恶性的关系以及恶性肿瘤的预后。结果170例足踝部肿瘤及瘤样病变中，男91例，女79例。骨肿瘤51例，软组织肿瘤119例。良性126例，恶性44例。年龄7个月-76岁，中位年龄32岁，平均年龄33．1岁。良性肿瘤以10-19岁和20-29岁最多，平均年龄29．54岁；恶性肿瘤以40-49岁和50-59岁最多，平均年龄为43．73岁。临床出现皮损往往提示恶性肿瘤。足踝部肿瘤主要以软组织肿瘤和良性肿瘤为主。软组织良性肿瘤以腱鞘巨细胞瘤最为多见；骨的良性肿瘤以甲下外生骨疣和内生软骨瘤最为多见。软组织恶性肿瘤以黑色素瘤和滑膜肉瘤最为常见。骨的原发恶性肿瘤和转移瘤均非常罕见。前足是肿瘤好发的解剖学部位。软组织肿瘤的大小与良恶性没有相关性，骨肿瘤的肿瘤大小与良恶性显著相关。44例恶性肿瘤中16例采用保肢术，28例截肢（趾）。平均随访时间32．4月，6例无瘤存活，5年无瘤生存率16．13％。结论足踝部肿瘤和瘤样病变以软组织肿瘤和良性肿瘤最为常见，恶性肿瘤发病年龄较高，出现皮损提示恶性肿瘤可能，前足是肿瘤的好发部位，骨肿瘤大小与良恶性相关，恶性肿瘤的预后较差。Purpose To investigate epidemiology and clinical features of tumors and tumor-like lesions of the foot and ankle, as well as prognosis of malignant tumors. Methods A total of 170 patients, surgically treated for bone and soft tissue tumors of the feet and ankle between 1984 and 2009 in a tertiary referral center specializing in orthopedic ontology, were enrolled in this retrospective study. The age, gender, clinical feature, tumor types, anatomical sites, the correlation between tumor size and tumor types, and the prognosis of malignant tumor were analyzed. Results There were 91 males and 79 females, aged from 7 mouths to 76 years （average, 33.1 years）. There were 51 cases of bone tumor and 119 cases of soft tissue tumor. Beuign tumors commonly occurred in the second and third decades of life, with an average age of 29.54 years, while most malignant tumors occurred in patients aged between 40 and 59 years, with an average age of 43.73 years. Skin lesion was a symptom implying malignanee. Soft tissue tumor and benign tumor were the most common types in the foot and ankle. Giant cell tumor of the tendon sheath was the most common type among benign soft tissue tumors; subungnal exostosis and enchondroma were the most commou types among benign osseous tumors; while melanoma and synovial sarcoma were the most common types among malignant soft tissue lesious. Both primary and metastatic bone tumors were very rare. Forefoot was the most common site where foot and ankle tumors happened. There was no correlation between tumor size and types of soft tissue tumor, while there was a high correlation between tumor size and types of bone tumor. Among 44 patients with malignant tumor, 16 patients underwent limb salvage surgery, while 28 patients underwent amputation. The mean duration of follow-up was 32.4 months. Six patients survived with no evidence of disease. The 5-year survival rate was 16.13%. Conclusion Benign and soft tissue tumors are the most common tumors in the foot and ankle. Most malignant tumors occur in pat

关 键 词：足 踝 肿瘤 回顾性研究 

分 类 号：R739.96[医药卫生—肿瘤]