喉巨大软骨肉瘤一例

患者 男,67岁.声音嘶哑10余年,颈部肿块3个月,生长迅速.纤维喉镜检查见双侧梨状窝圆形新生物,左侧表面光滑,突入下咽部喉腔,右侧表面糜烂、凹陷;环后隙被肿物充填,下咽部两侧壁、后壁均可见肿物.频闪喉镜示左侧下咽可见巨大球形肿物,颜色淡红,表面光滑,质硬.肿物使声门向前向右推移,声门裂狭窄,会厌黏膜光滑.颈部B超:双侧颌下探及多个肿大淋巴结,大的位于右侧,大小为1.2 cm×0.5 cm,界清.     

肋骨软骨肉瘤一例

病例资料患者,女,56岁。胸痛、咳嗽、咳痰10天入院就诊。查体:左侧腰背部第8后肋处压痛,左下肺呼吸音稍减弱,叩诊呈浊音,无特殊既往史。胸部CT检查:CT平扫示第8胸椎左侧一大小约5.8cm×6.4cm团状软组织影,突向肺野,边缘尚光整,密度不均,内可见斑片状、沙粒状高密度钙化灶(图1),邻近左侧第8后肋骨骨质膨胀,可见虫蚀样不规则骨质破坏(图2),考虑为周围性肺癌合并肋骨转移可能性大。手术所见:     

胸骨软骨肉瘤一例

患者　女 ,2 3岁。胸部肿块 5年 ,近 2个月来肿块明显增长 ,大如核桃 ,轻微疼痛。曾在当地医院按胸壁结核给予抗结核治疗 1个月 ,效果不佳。查体 :胸骨柄右侧可见 4ｃｍ× 3ｃｍ大小的肿块 ,质中等 ,表面光滑 ,触压痛阳性 ,边界清 ,活动度差。右侧胸锁关节处可见 1.5ｃｍ× 1.0ｃｍ大小的肿块 ,与锁骨关系密切 ,质硬。Ｘ线表现 :胸骨前上方可见一密度增高且不均匀的肿块影 ,其内有 1ｃｍ× 4ｃｍ的钙化灶 ,病变区骨质结构模糊不清 ,似有破坏征象 (附图 )。Ｂ超检查 :胸骨柄前方见一大小约 6.6ｃｍ× 3 .0ｃｍ× 4.8ｃｍ的低回声为主的肿块 ,…     

腮腺软骨肉瘤一例

患者 男,54岁.左侧面神经麻痹4年,左腮腺区肿块伴疼痛1周.于2012年7月25日入院.1周前无意中发现左侧耳下一鸡蛋大小肿块,伴疼痛,生长较快,于外院对症抗炎治疗,效果不佳而转我院就诊.体检:左腮腺扪及一肿块,大小约4cm×3cm×3 cm,质偏硬,界尚清,相对固定,与周围组织粘连,轻度触痛,表面无充血、破溃;左眼睑闭合不全,额纹消失,鼻唇沟变浅,口角歪斜,口内腮腺导管无红肿,未见异常分泌物.实验室检查:血常规、尿常规、肝肾功能正常.     

卵巢软骨肉瘤一例

患者　女,47岁。因下腹部肿块伴月经不调半年来院就诊。体检:下腹膨隆,正中可扪及一120ｃｍ×110ｃｍ×105ｃｍ大小肿块,质硬,活动度差。实验室检查无异常。静脉尿路造影示:膀胱轻度向右前移位。Ｂ超于子宫左后方探及一约136ｃｍ×137ｃｍ×115ｃｍ大小实质性肿块,内有多量强回声光点及条弧状影。ＣＴ平扫示盆腔内正中略偏左有一138ｃｍ×135ｃｍ×112ｃｍ大小肿块,呈多房状,房隔粗厚,密度高,ＣＴ值689～753ＨＵ;房大小不一,密度不均,内有大量斑点状钙化影,ＣＴ值83～297ＨＵ。肿块与子宫分界不清,与盆腔其他组织间境界清楚,盆腔内未见肿大…     

肋骨软骨肉瘤一例

目的:探讨膝关节内、外侧半月板撕裂在导致胫骨髁间后区积液方面的差异及其可能原因。方法:按照分层随机抽样原则抽取孤立性内侧半月板撕裂68例,孤立性外侧半月板撕裂65例,对内、外侧半月板撕裂在引起胫骨髁间后区积液方面的差异进行χ2检验。结果:68例内侧半月板撕裂病例中发现胫骨髁间后区积液59例,发生率为86.7%;65例外侧半月板撕裂病例中发现胫骨髁间后区积液41例,发生率为63.1%,两组比较差异有统计学意义(χ2=9.99,P<0.05)。结论:孤立性内、外侧半月板损伤在引起胫骨髁间后区积液方面的差异是由它们不同的解剖特点所决定的。其原因可能与受损半月板刺破包裹交叉韧带的滑膜或半月板脱位过分牵拉致滑膜破裂后关节腔积液涌入胫骨髁间后区有关。     

巨大软骨肉瘤一例

患者女,65岁。2年前于左大腿上段触及一椭圆形质硬肿物,有压痛,左下肢行走无明显影响,肿物生长缓慢,患者一直未予诊治。近日突然感左大腿剧烈疼痛,伴有左下肢活动受限。体检:左下肢皮肤、软组织完整,局部皮肤无红肿、破溃,无表浅静脉曲张,左股骨近端可触及大小约10 cm×8 cm质硬肿物,表面尚光滑,基底部固定,不可推动,与周围组织分界尚清,肿物表面轻度压痛,无明显放射痛,局部皮     

肋骨软骨肉瘤一例

患者女,64岁。左侧腹部肿块半年入院。超声检查:左侧腰部距皮下1cm处可见14cm×15cm大小囊实性肿物,明显外突,其上缘平剑突水平,下缘平髂前上棘,边界尚清,形态尚规则,可见完整包膜。其内回声强弱不等,分布不均,并可见不规则液性暗区,其周边及内部可见少量点状血管流空信号。腹腔未探及明显积液。印象:左腰部囊实性肿物(考虑来源于腹膜后:①畸胎瘤;②神经纤维瘤)。CT检查:肝右叶可见点状钙化。左下腹左肾下极后外侧可见软组织肿块灶,边缘尚清晰,下至左侧髂骨,最大层面约14cm×16cm大小,密度不均,其中散在斑片状钙化,CT值15~256HU,有包膜。…     

下颌骨软骨肉瘤一例

患者　女,32岁。左腮腺区肿物2个月,加速生长1周。2个月前无意中发现,无疼痛及不适感,随后该肿物渐进性增大。近1周生长迅速,且出现疼痛和不适感,张口受限。体检:左右颌面部不对称,左侧膨隆。左耳前可扪及一大小约4 .0cm×2 .0cm椭圆形肿物,前界为咬肌前缘,下界为下颌骨下缘,上界为颧弓下缘,后界为耳屏前。质地较硬,表面光滑,境界清楚,活动度差。张口度两横指,腮腺导管口无红肿,轻挤压腺体见清亮分泌物流出。B超:左侧耳前探及4 .1cm×2 .0cm实性肿物,有包膜,内部回声不均,可见多个钙化点,彩色多普勒示较丰富血流信号CT所见:下颌骨左侧升支…     

股骨上段软骨肉瘤1例

患者男,28岁。患者感觉右髋关节疼,2004年2月疼痛加重,右股骨骨肿胀来就诊。体检:右股骨明显肿胀压疼,右髋关节活动受限,无明显发热。X线所见:右侧股骨颈,大小粗隆及股骨上端呈梭形膨胀变界较清晰,大小约12cm×15cm,其腔内见不规则的骨脊及团块高密度絮状影,骨皮质破坏,周围软组织密度略增高(图1,2)。X线诊断:①软骨黏液纤维瘤;②软骨肉瘤。手术所见:肿瘤呈灰色为疏松的骨小梁结构,中间呈岛状分布着胶冻样瘤组织,及软骨样组织,图1双髋关节正位图2右髋关节正位,显示股骨上端呈梭形膨胀,骨皮质破坏周围软组织内见少量瘤体样组织。切开股骨头,…     

鼻腔软骨肉瘤1例

患者 女,67岁.因"左鼻阻、溢泪伴左鼻面部、头部疼痛1月"入院.体查:外鼻无明显畸形,左鼻孔及鼻咽部见一肿物填充,质硬,表明坏死,鼻腔内结构不能窥及,鼻中隔向右偏曲.实验室检查无阳性发现.副鼻窦CT(图1,2):左侧鼻腔见最大层面约32mm×28mm软组织影填充,累及左侧上颌窦、筛窦及鼻咽部,内见斑点状钙化影,左侧鼻甲、上颌窦壁骨质破坏.镜示:肿瘤由软骨基质及软骨细胞构成、排列紊乱,部分核异型.免疫组化:肿瘤细胞表达Vimentin(+),S-100(+),CD68(-),CK(-),HMB45(-),Desimn(-),CD34(-).病理诊断:软骨肉瘤Ⅱ级(图3,4).     

Chondrosarcoma of the larynx: treatment with radiotherapy

The case of a 50-year-old man with chondrosarcoma of the larynx treated with radiotherapy is reported. The patient presented with hoarseness and dyspnea. He underwent computed tomography (CT), which demonstrated a soft tissue mass of the larynx. Direct laryngoscopy with biopsy established the diagnosis of chondrosarcoma. Although experience with radiotherapy in these cases has been lacking in the literature, it was considered and eventually used, as radical surgery would result in severe cosmetic and functional impairment. Radiation therapy alone resulted in long-term remission of the tumour for more than 3 years. The patient has been followed up using CT and direct laryngoscopy for early detection of recurrence or metastases.     

Chondrosarcoma of the larynx. Report of a case with characteristic computed tomography findings

Chondrosarcoma of the larynx is a rare lesion. Computed tomography was able to suggest this diagnosis preoperatively and aided in surgical planning by defining the extent of the mass in a 67-year-old man who presented with signs and symptoms of airway obstruction.     

Case report: extramedullary plasmacytoma of the larynx.

A case of extramedullary plasmacytoma of the larynx is presented. The case is unique for the extramedullary plasmacytoma's marked extension into the mediastinum. The computed tomography (CT) features are described.     

Chondrosarcoma of bone complicating Ollier's disease: report of a favourable response to radiotherapy

Because chondrosarcoma of bone is traditionally thought to be a radioresistant malignancy, it is usually managed surgically. We report a case of multifocal chondrosarcoma arising in Ollier's disease for which the patient declined surgery. He was given a course of radical radiotherapy that resulted in symptom palliation and a radiologically confirmed response before he died of disseminated disease. In patients with inoperable chondrosarcoma, radiotherapy can provide palliative benefit.     

Solitary fibrous tumor of the larynx: case report demonstrating the value of MRI in guiding surgical management

A 74-year-old woman presented with persistent dysphagia, dysphonia, and throat gurgling. Prior intraoperative biopsies were negative, and outside imaging revealed supraglottic swelling. Magnetic resonance imaging (MRI) demonstrated a well-defined T1 and T2 hypointense, avidly enhancing hypopharyngeal mass. Deep intraoperative rebiopsies revealed a tumor with CD34 + tissue, diagnostic of a solitary fibrous tumor. A broad range of nonsquamous cell tumors should be considered when a submucosal laryngeal mass is encountered. MRI may be particularly helpful in guiding appropriate biopsy.