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骨腫瘍의 臨床的 考察

Clinical Observations on Bone Tumors

대한외과학회지 1964년 6권 2호 p.85 ~ 99
문명상,
소속 상세정보
문명상 (  ) - 서울대학교 의과대학 외과학교실

Abstract


Clinical observations were presented on 77 cases of bone tumors who were admitted to the department of surgery, Seoul National Univ. Hospital from January 1955 to October 15 1963
1) 77 cases of bone tumors are classified by their malignancy.
Among 19 cases of benign tumors;
a. Osteochondroma (Exostosis), Solitary and multiple 9
b. Chondroma 3
c. Osteoid osteoma 1
d. Osteoma 1
e. Giant cell tumor 3
f. Fitrous dysplasia 1
g. Aneurysmal bone cyst 1
Among 58 malignant tumors;
a. Ostegenic sarcoma 13
b. Chondrosarcoma 3
c. Osteochondrosarcoma 1
4. Reticulum cell sarcoma 3
e. Ewing´s sarcoma 1
f. Multiple myeloma 2
g. Malignant giant cell tumor 1
h. Fibrosarcoma 1
i. Anaplastic sarcoma 1
j. Neurogenic sarcoma 2
k. Carcinoma
metastatic 9
by direct invasion 20
l. Malignant lymphoma 1
2) Ratio between benign and malignant tumors is 19:58. Ratio between carcinoma and sarcoma of bones is 29:29. Among 29 cases of carcinoma of bones 9 cases are metastatic deposits and remainders are due to direct invasion. Among 10 cases of metastatic tumors in bone, 9 cases were of epithelial origin.
3) Among 77 cases 36 cases are tumors of osseous origin, of which 16 are cartilaginous, 15 cases are osseous, and 5 cases are resorptive in origin. Among 41 cases of bone tumors of nonosseous origin, 6 cases are from marrow, 10 cases are metastatic, and 25 cases are by inclusion or direct invasion.
4) Most of the 19 cases of histologically benign bone tumors were under 40 years of age as with 29 cases of sarcoma of bones, whereas most of the 29 cases of carcinomatous tumors were over 40 years of age.
5) Sex distribution between male and female are 52:25, in benign tumors 14.5, in carcinomatous tumors 17·12, and in sarcomatous tumors 20:9.
6) Geographical distribution of patients shows high incidence in Seoul and Kyong-Ki Province reaching to 39 cases.
7) In 2 cases of osteochondroma heredity is recognized.
8) Skeletal sites involved are;
a. Maxilla 30
b. Tibia 12
c. Humerus 9
d. Femur 7
e. Vertebra 5
f. Sacrum 3 etc.
In benign tumors, skeletal sites involved are;
a. Tibia 9
b. Humerus 3
c. Femur 2
d. Radius 2
In Carcinomatous tumors except maxillary carcinoma;
a. Vertebra 2
b. Humerus 1
c. Mandible 1
d. Clavicle 1
e. Sacrum 1
In sarcomatous tumors except manillary sarcoma;
a. Femur 5
b. Humerus 5
c. Tibia 4
d. Spine 2
e. Sacrum 2
9) Radiologically bone destruction was observed in 72% of malignant tumors at their early stage. Pathological fracture was confirmed in 7 cases. among which 3 were giant cell tumors. Almost all of casses had swelling of the soft tissue, haziness and irregularity of bone contour.
10) Generally malignant cases had anemia and A/G of almost 1:1 or reversed. Mild eosinophilia was noted.
11) Radical resection and curettage with or without bone graft were carried out in 19 cases of benign tumors without any operative mortality. Among 58 cases of malignant tumors, 17 cases received conservative treatment only, of which cases had X-ray irradiation. 1 case had chemotherapeutic agent- Nitromin, and 1 case had X-ray irradiation with Exdoxan. Among 41 cases who received surgery, 38 cases had radical operation, 3 had laminectomy. 28 cases received X-ray irradiation, and 1 case received X-ray irradiation and chemotherapeutic agent Endoxan.
Follow-up study was ended unsuccessful due to lack of cooperation of patients.

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