Dedifferentiated chondrosarcoma

We reviewed 74 cases of dedifferentiated central and peripheral chondrosarcoma. Histologically these tumours consist of an underlying cartilaginous component (either benign or malignant) juxtaposed to a highgrade non-cartilaginous component, with a typically abrupt transition between the two tissue types. The noncartilaginous component may constitute a very small or a very large proportion of the tumour, so diagnosis often requires histological evaluation of the entire tumour. The diagnosis is often suspected on the basis of the clinical course and careful evaluation of the radiographie characteristics. Central dedifferentiated chondrosarcoma can be classified radiographically into three types. In type 1 (36 cases in our review) the radiographie features are the same as those of a central chondrosarcoma, with the addition of a region with very aggressive radiographie features. Type 2 lesions (20 cases) resemble the underlying benign enchondroma but also have destructive changes and/or a large soft tissue mass. Type 3 lesions (8 cases) are not distinctive radiographically and present as a very high grade destructive lesion of bone. These cases are diagnosed following biopsy or tumour resection. The prognosis of these tumours is extremely poor, with 13% overall 5-year survival in this series. Improved survival was found in those cases where diagnosis was prompt and surgical treatment with a wide or radical margin was attained. No benefit was found from the use of adjuvant chemotherapy or radiotherapy. Thus, early recognition of the characteristic radiographie features, adequate histological sampling, and wide or radical surgical margins are necessary for satisfactory management of this highly malignant variant of chondrosarcoma.     

Chondroma of the bladder

 This case report describes a chondroma of the bladder in a 63-year-old woman with clinical complaints of pain in the left fossa iliaca. The lesion was a tumour with a lobulated growth pattern composed of chondrocytes embedded in a chondroid matrix. Neither mitotic figures nor increased cellularity were present. Nuclei were inconspicuous. Immunohistochemical examination showed reactivity for S100 and vimentin. Received: 22 April 1997 / Accepted: 25 August 1997     

右主支气管软骨瘤1例

患者男,56岁。1个月前无明显诱因出现咳嗽、咳痰,咳嗽以清晨起床后及剧烈活动后明显,咳嗽时伴有胸闷,白色黏痰,量不多,咳出后胸闷感减轻。无发热、盗汗、胸痛及咳血史。7天前在本地医院胸透发现纵隔移位来院就诊。查体：口唇无紫绀,气管右偏,右侧胸廓明显缩小,吸气时无“三凹征”,听诊右肺闻及哮鸣音。     

肺软骨瘤1例

患者女，60岁。刺激性干咳1个月，发现左下肺占位1周入院。CT：左肺下叶外基底段近胸膜处见直径约5．5mm小结节灶，CT值约48Hu，边界清晰，其内可见斑点状钙化，局部可见胸膜凹陷征，周围未见卫星病灶及浸润影（图1）。CT诊断：左肺下叶良性结节，性质待定。病理诊断：左肺下叶软骨性肿瘤，分化好。     

Intra-articular chondroma of the knee

Chondromas are tumours that develop in relation to the periosteum and, although they are common around the knee, most reports deal with soft tissue chondromas in para-articular locations or intracortical tumours in extra-articular regions. We report a rare case of an intra-articular chondroma in a 16-year-old boy of Asian origin developing in the region of the medial femoral condyle of the femur and extending into the femoral sulcus and the patellofemoral joint.     

颅内软骨瘤的临床特点

目的 提高对颅内软骨瘤临床特点及诊治方法的认识.方法 回顾性分析经病理学证实的30例颅内软骨瘤病人的临床资料、影像学特点及治疗方法.全部病人行手术治疗,5例病人术后行放射治疗.结果 颅内软骨瘤主要发生在颅底软骨的结合处,多见于中颅窝,临床表现为头痛及多组脑神经损害症状.影像表现多数伴有明显钙化,相邻骨质可受累.手术33例次,有3例病人复发后再次行手术治疗.肿瘤全切除11例次,近全切除13例次,大部及部分切除9例次.手术死亡1例.随访到26例病人,平均时间为45.8个月.恢复正常活动21例,复发3例,死亡2例.结论 颅内软骨瘤手术不易全切除,放疗效果不确定.临床和影像方面不易与黏液瘤及脊索瘤鉴别,病理仍是主要确诊手段.     

Intracranial falx chondroma: literature review and a case report

Intracranial chondromas are benign tumors that represent approximately 0.5% of all intracranial tumors. They usually occur at the base of the skull but on rare occasions might present as intra-parenchymal or intra-ventricular space-occupying lesions, most likely originating from heterotopic chondrocytes or metaplastic fibroblasts of the falx, the convexity dura, or the ventricular ependyma. Chondromas are slow-growing tumors, which remain clinically silent for a prolonged period of time in the majority of cases. Their clinical presentation is non-specific and their radiographic appearance usually does not differentiate them from their more common counterparts, such as meningiomas and glial tumors. As a result, their diagnosis has remained a histopathologic one. In our current study, we present a case of a falcine intracranial chondroma. This case provided the opportunity to extensively review the pertinent literature.     

邻皮质软骨瘤及骨外软骨瘤的X线表现(附20例38处病变分析)

本文报告了邻皮质软骨瘤及骨外软骨瘤20例共38处病变，对其X线征象进行了分型讨论，病变虽然罕见，但征象独特而典型，X线诊断有独到之处。