Giant Cell Tumor of Bone a Report of 24 Cases

骨巨細胞瘤－24病例報告

黃倫奕(Lun-Yick Wong) ； 楊東傑(Tung-Chieh Yang)

《中華放射線醫學雜誌》 10卷2期 (1985/06) Pp. 87-94

摘要

骨巨細胞瘤從病理組織上的定義是骨髓中間質組織體素不含骨組織的腫瘤。原發性惡性瘤很少，極大部份在初次發生時是良性。雖然如此，它的不穩定性甚著，目前尚無一種組織學上的方怯以鑑定何種良性腫瘤在手術後再發或預測何種腫瘋待會轉變為惡性。一般來說這種骨瘤在鋤哉上分為典型良性和惡性兩種，前者是在富有血管性的基質中交錯著一簇簇多邊形和多核巨細胞，兩者的細鮑核形狀和大小相似且無分裂性細胞核，後者為整個基質細識的肉瘤性變化。
馬偕紀念醫院從民國51年到71年，20年中發現有24個經手術和病理診斷的骨巨細胞瘤的病例，在經過整理分析和參考以往文獻後作一個簡單的報告。以年齡、性別、部位和特徵來說，我們發現年輕的－病例祇有14歲，最年老的為65歲，其中最高發生率往20至30歲之間，佔16例(67%)，男女比為10:14，最常侵犯部位為膝部，即股骨遠端和腔骨或腓骨近端，X光所見為擴張蝕骨性病灶，有時會破壞骨皮質而侵入鄰近的軟組織，但很少有骨膜反應，有病理性骨折時亦然。所有24個病例皆有疼痛和腫脹，期間從兩週到九個月不等。

並列摘要

A series of 24 cases of giant cell tumor of bone collected from 1962-1982 at the Mackay Memorial Hospital has been analized regarding the age incidence, location of occurrence, the rate of recurrence and other characteristics of these tumors. Comparison and review with other reports were made.
The typical tumors show expanded lytic lesions in the end of long bone, usually eccentrically located and all patients are skeletally mature. Histologically the microscopic features of the tumors are generally designated as typical or malignant. The typical tumor has a vascular stroma of plump polyhedral cells diffusely interspersed with multinucleated giant cells the characteristic of malignant giant cell tumor is the frankly sarcomatous nature of the stromal elements. There are no reliable histological means for identifying the benign giant cell tumor that are most likely to recur or for predicting which tumor will become malignant.