青春期及儿童骨巨细胞瘤14例报告

目的：总结青春期及儿童骨巨细胞瘤（ＧｉａｎｔＣｅｌＴｕｍｏｒｏｆＢｏｎｅ，ＧＣＴ）的临床表现、放射学特点及治疗。方法：１４例青春期及儿童ＧＣＴ选自１９５７～１９９５年我科收治的２１６例ＧＣＴ病人，随访２～１２年，总结其临床表现，放射学特点，治疗及随访结果。结果：青春期及儿童ＧＣＴ占全部ＧＣＴ的６５％，１３／１４发生于１５～１８岁，临床表现以疼痛、肿胀为主，并发病理骨折者较成人ＧＣＴ发生率高；放射学改变为溶骨性改变，位于干骺端者较成年组多见。临床分期２期以下（１１／１４），行病灶刮除、５０％氯化锌水溶液烧灼瘤腔壁＋植骨，３期行瘤段切除或截肢，全部病人无复发或转移，功能优良率达９１７％。结论：青春期及儿童ＧＣＴ较多位于干骺端，绝大多数属于临床２期，行刮除＋５０％氯化锌烧灼＋植骨的方法可以达到较理想的疗效

Giant Cell Tumor of Bone in Children and Adolescents: Report of 14 Cases.

Objective:To summarize the clinical and radiological characteristics and treatment methods of giant cell tumor of bone (GCT) in children and adolescents. Method: Clinical and radiological appearance, treatment methods and followup results were retrospectively assessed in 14 patients less than 19 years of age out of 216 GCT cases in our institute from 1957 to 1995. The followup were of 2 to 12 years. Results: GCTs in children and adolescents account for 6.5% of all GCTs. Among our patients 9 were girls, 13 of 14 were 15 to 18 years old. Pain and swelling were the main symptoms. There was a higher rate of occurrence of lesions in metaphysis in children and adolescents as compared with in adults. 10 cases of stage 2 and 1 were treated by curretage, cautery with 50% aqueous solution of zinc chloride and bone grafting while the remaining 4 by en bloc resection or amputation. No recurrence or metastasis occurred in all 14 patients. 91.7% of the cases achieved excellent or good functional results. Conclusion: GCTs in children and adolescents are more frequently found in metaphysis and curretage, cautery with 50% zinc chloride and bone grafting can achieve good resutls to patients of stage 2 and 1, who account for majority of them.