骨軟骨瘤併發惡性病變──個案報告

Osteochondroma with Malignant Transformation: A Case Report

一個40歲的女性，最近一年來有左腿疼痛及彎曲困難，電腦斷層攝影發現有一個骨軟骨瘤伴有一軟組織腫瘤，病理顯示骨軟骨瘤併有惡性變化。單一性骨軟骨瘤約有百分之一的比例會有惡性變化，手術前判斷骨軟骨瘤有沒有惡性變化對於術前計畫及病人的治療相當重要。本章例在手術後追蹤檢查三年，發現手術殘餘腫瘤並沒有變大，也沒有轉移，說明這腫瘤生長的速度很慢，是一個低度惡性腫瘤，並且可能不易早期轉移。

A 40-year-old female had the chief complaint of mild pain in her left thigh and had difficulty flexing her left leg for 1 year. Plain rediography of her left hip showed a huge ossified mass superimposed on the left femoral neck. CT revealed a huge osteochondroma arising from the left femoral neck with a large soft tissue mass. Due to the large soft tissue component, osteochondroma with malignant change is considered. Under the impression of malignant transformation of the osteochondroma, she underwent operation with nearly total resection of the tumor. Pathologic finding showed an osteochondroma with malignant transformation. The symptoms were relieved after the operation. The patient is doing well and has had no metastases after 3 years.