Primary giant cell tumor of soft tissues - A study of 22 cases
Primary giant cell tumor of soft tissues - A study of 22 cases
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DOI：
10.1097/00000478-200002000-00011
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发表时间：
2000-02-01
影响因子：
5.6
通讯作者：
Nascimento, AG
中科院分区：
文献类型：
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作者：
Oliveira, AM;Dei Tos, AP;Nascimento, AG
报告22例软组织骨巨细胞瘤(GCT-ST)，均见于Mayo临床和两位作者(A.G.N，C.D.M.F.)的会诊档案。进行了临床病理分析。发病年龄从5岁到80岁(中位数43岁)，没有性别偏好(男性12例，女性10例)。症状持续时间为2至12个月(中位数为4.5个月)，最常见的主诉是无痛性肿块增长。发病部位以下肢最多(50%)，其次为躯干(31.8%)和上肢(13.6%)。肿瘤大小为1~10 cm，多为浅表肿块(86.4%)、边界清楚(72.7%)、多结节(86.4%)。组织学上，所有肿瘤均由单个核细胞组成，呈泡状、圆形至椭圆形核，破骨细胞样多核巨细胞均匀分布于肿瘤各处。间质出血灶11例(50%)，化生骨形成9例(40.1%)，动脉瘤样骨囊样病变6例(27.2%)。除1例肿瘤外，其余肿瘤均未见坏死。除1例外，其余肿瘤均可见有丝分裂像，每10个高倍视野可见2个至30个以上的有丝分裂像(HPF中位数为9.5个/10个HPF)，且形态典型。肿瘤血管侵犯7例(31.8%)，无明显细胞异型性或多形性。这些肿瘤接受了手术治疗，16名患者获得了随访信息(随访时间为2至130个月；中位数为51个月)。16例患者中只有1例(6.2%)有局部复发和肺转移；这位患者死于肿瘤。综上所述，GCT-ST是一种原发的软组织肿瘤，在临床和形态上与骨巨细胞瘤相同。如果完全切除GCT-ST得到了充分的治疗，由于远处转移和肿瘤相关死亡的发生似乎非常罕见，因此良性的临床病程是可望的。
Twenty-two cases of giant cell tumor of soft tissues (GCT-ST) identified in the Mayo Clinic files and the consultation files of two of the authors (A.G.N,, C.D.M.F.) were analyzed clinicopathologically. Age at presentation ranged from 5 to 80 years (median, 43 years), and there was no sex predilection(12 male, 10 female). Duration of symptoms ranged from 2 to 12 months (median, 4.5 months), and a painless growing mass was the most common complaint. The lower limbs were the most frequent location (50%), followed by the trunk (31.8%) and the upper limbs (13.6%). The size of the tumors ranged from 1 to 10 cm, and they tended to be superficial (86.4%), forming well-circumscribed (72.7%), multinodular (86.4%) masses. Histologically, all tumors consisted of a mixture of mononuclear cells showing vesicular, round to oval nuclei and osteoclastlike, multinucleated giant cells distributed uniformly throughout the tumors. Foci of stromal hemorrhage were observed in 11 tumors (50%); nine tumors (40.1%) showed metaplastic bone formation and six (27.2%) showed aneurysmal bone cystlike areas. Necrosis was absent in all but one tumor. Mitotic figures were present in all but one tumor, ranging from two to more than 30 mitoses per 10 high-power fields (HPFs median, 9.5 mitoses per 10 HPFs) and were typical in aspect. Vascular invasion was identified in seven tumors (31.8%), and none of the tumors showed marked cellular atypia or pleomorphism. The tumors were treated surgically, and follow-up information was available for 16 patients (duration of follow-up, 2 to 130 months; median, 51 months). Only one of the 16 patients (6.2%) had local recurrence and lung metastases; this patient died of the tumor. In conclusion, GCT-ST occurs as a primary soft-tissue neoplasm and is identical clinically and morphologically to giant cell tumor of bone. Provided that GCT-ST is treated adequately by complete excision, a benign clinical course is expected because episodes of distant metastasis and tumor-associated death seem to be exceedingly rare.