股骨近端平滑肌肉瘤1例并文献复习

目的探讨骨平滑肌肉瘤的临床表现、诊断和治疗。方法对1例骨原发性平滑肌肉瘤进行临床和病理资料观察。复习有关文献,就骨原发性平滑肌肉瘤发病情况、组织来源、病理、诊断、鉴别诊断、治疗和预后进行了讨论。结果骨原发性平滑肌肉瘤好发于股骨远端和胫骨近端,尤其是膝关节附近。临床最常见症状是疼痛,可伴有关节活动受限。X线显示长骨干骺端不规则低密度影。组织学、免疫组织化学标记表达具有特征。结论骨原发性平滑肌肉瘤比较少见,诊断主要靠免疫组化。宜采取手术治疗,可辅以放疗或化疗。

Leiomyosarcoma of the proximal femur and review of the literature

Objective To analyze the clinical features of leiomyosarcoma of the bone,its diagnosis and therapeutics were studied.Methods One case of leiomyosarcoma was studied with clinicopathological analysis,immunohistochemical staining.Through reviewing literature,the morbidity,the histological appearance,the pathology,the diagnosis,the differential diagnosis,the treatment and the prognosis of bone leiomyosarcoma were explored.Results The predominant sites of occurrence were the metaphysis of long bones,particularly the lower end of the femur and the upper end of the tibia.The most common symptom was pain in clinic,with dysfunction of the joint.X-ray examination showed a permeated destruction in the metaphysic of the bone.The microscopic features and immunohistochemical stains of leiomyosarcoma were typical.Conclusion Leiomyosarcoma of bone is rare.The diagnosis depends on immunohistochemistry.The treatment depended on the surgical operation,assisting with the radiotherapy or chemotherapy.