摘要
原發性胸壁骨肉瘤非常少見，我們報告一例左側胸壁巨大骨肉瘤。一位40歲男性病患，主述左側背疼痛有數週，胸部X光及電腦斷層掃瞄發現，左胸壁有一巨大腫瘤且侵犯胸主動脈，經超音波穿刺切片檢查並無法得到確切之診斷，因此接受胸壁腫瘤的外科切除手術，根據組織病理化驗，確定診斷為骨肉瘤，在手術之後他繼之接受輔助性化學藥物治療，病患於手術後十三個月，死於局部擴散及肺部轉移。 如同少數高度惡性腫瘤，針對原發性胸壁骨肉瘤之治療方法並無定論。但一般可接受之治療方法為，早期診斷及外科手術切除，而足夠的安全切除邊緣為一重要的預後因子。手術之後的輔助性化學藥物治療或放射治療並無定論。
並列摘要
Primary osteosarcomas of the chest wall are very rare. We report a patient with a large osteosarcoma of the left chest wall. This 40-year-old man suffered from left chest pain for several weeks, and chest radiological examinations revealed a tumor mass, 15×15×20 cm in size, in the left chest wall firmly adherent to the aortic arch. Sono-guided needle biopsy was performed, but a histological diagnosis could not be obtained. Complete surgical resection of the tumor was attempted, but failed due to aortic wall involvement. Postoperative chemotherapy was administered with a poor response. The patient died of carcinomatosis within 13 months after surgery. The optimal therapeutic strategy for primary chest wall osteosarcoma, a rare tumor with a high grade malignancy, is not well defined. However, it is generally accepted that early diagnosis plus complete resection with adequate safe margins are the important factors that will determine the prognosis. The role of chemotherapy or radiotherapy has not been well clarified in the treatment of this neoplasm.
延伸閱讀
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