摘要
目的探讨儿童腱鞘巨细胞瘤(giant cell tumor of tendon sheath,GCTTS)的临床表现、影像学特点及治疗方法,以提高临床医生对本病的认识。方法检索万方、维普、CNKI、PubMed、Medline数据库有关儿童GCTTS的文献,结合南京医科大学附属儿童医院收治的2例患者的临床资料进行分析。结果文献报道且符合本研究要求的GCTTS患者29例,结合本院2例,共31例GCTTS患者纳入本研究,其中男14例,女17例,年龄2~10岁(平均7岁7个月)。主要临床表现为无痛性包块(12/31,38.7%),发病部位最多见于膝关节(12/31,38.7%)和手指(10/31,32.3%)。B超检查提示低回声包块信号,X线检查阳性率不高(34.6%),主要表现为溶骨性骨破坏及软组织肿块,CT检查均表现为骨质破坏伴软组织肿胀,MRI检查主要表现为T1加权像低至中等信号强度,T2加权像低信号强度。病理表现主要由成纤维细胞、滑膜样单核细胞、泡沫样细胞和巨噬细胞组成。术后随访,1~156个月(平均随访时间为38个月),明确术后复发1例。结论儿童GCTTS非常少见,术前X线平片检查、超声检查、CT检查结合磁共振检查有助于初步诊断GCTTS,但明确诊断仍需要结合组织病理学检查,首次规范化手术是治疗成败的关键,需加强对GCTTS患者的长期随访。
Objective To explore the clinical manifestations,pathological changes and treatments of giant cell tumor of tendon sheath(GCTTS)in children aged under 10 years so as to improve its understanding.Methods Two cases of GCTTS were selected from our hospital while 29 more cases retrieved from the databases of Wanfang,Weipu,CNKI,PubMed and Medline.Results Among 31 GCTTS children,there were 14 boys and 17 girls with a mean age of 91(24-120)months.One major clinical manifestation was painless mass(n=12,38.7%)and the most common sites included knee joints(n=12,38.7%)and fingers(n=10,32.3%).Ultrasound was manifested mostly as hypoechoic mass.The positive rate of radiographic examination was not high(34.6%).And osteolytic bone destruction and soft tissue mass were visualized.Computed tomography(CT)revealed bone destruction accompanied by soft tissue swelling.The predominant findings of magnetic resonance imaging(MRI)were low-to-moderate signal intensity on T1-weighted images and low signal intensity on T2-weighted images.The mean postoperative follow-up period was 38(1-156)months.There was only one confirmed case of postoperative recurrence.Conclusion Pediatric GCTTS is quite rare.Preoperative radiograph,ultrasound and CT/MRI examinations are helpful for an initial diagnosis of GCTTS.However,histopathological examination is required for a definite diagnosis.Initial standardized surgery is vital for the treatment of GCTTS and long-term follow-ups should be strengthened.
作者
高志鹏
林刚
鞠黎
Gao Zhipeng;Lin Gang;Ju Li(Department of Orthopedics,Affiliated Children's Hospital,Nanjing Medical University,Nanjing 210000,China.)
出处
《临床小儿外科杂志》
CAS
CSCD
2021年第6期562-568,共7页
Journal of Clinical Pediatric Surgery
关键词
腱鞘巨细胞瘤/诊断
腱鞘巨细胞瘤/外科学
抗肿瘤联合化疗方案
复发
儿童
Giant Cell Tumor of Tendon Sheath/DI
Giant Cell Tumor of Tendon Sheath/SU
Antineoplastic Combined Chemotherapy Protocols
Recurrence
Child
