-
原发性乳腺骨肉瘤(primary osteosarcoma of the breast,POB)是罕见的恶性间叶性肿瘤,是骨外骨肉瘤的一种,其发病率不到乳腺恶性肿瘤的1%,占乳腺肉瘤的12.5%[1]。POB与肉瘤有相似的生物学特性,具有高度侵袭性、易血行转移至肺、较少转移至腋下淋巴结和预后差等特点。笔者对一例POB患者的临床资料进行分析,结合文献总结其影像学特征,以提高对该病的认识。
原发性乳腺骨肉瘤99Tcm-MDP全身骨显像一例
99Tcm-MDP whole body bone imaging in primary osteosarcoma of the breast: a case report
-
摘要: 笔者报道了一例原发性乳腺骨肉瘤(POB)的99Tcm-MDP SPECT全身骨显像病例,分别从临床症状、实验室检查、超声、CT及99Tcm-MDP全身骨显像等方面分析了该病的特点,并通过文献回顾总结了POB的影像学特征。POB临床罕见,99Tcm-MDP全身骨显像有助于发现转移灶、多灶病变、疾病的鉴别诊断及临床分期,具有一定的临床意义。Abstract: The authors report a case of primary osteosarcoma of the breast (POB) on 99Tcm-MDP whole body bone imaging. The characteristics of the disease were analyzed from the clinical symptoms, laboratory examination, ultrasound, CT and the whole body bone imaging. To summarize the imaging features of POB through literature review. POB is rare clinically, 99Tcm-MDP whole body bone imaging can help to find out the metastases, multifocal lesions, differential diagnosis and clinical staging of the disease, it has certain clinical significance.
-
Key words:
-
-
[1] Al Samaraee A, Angamuthu N, Fasih T. Primary breast osteosarcoma: a case report and review of literature[J]. Scott Med J, 2014, 59(4): e1−e4. DOI: 10.1177/0036933014551674. [2] Krishnamurthy A. Primary breast osteosarcoma: A diagnostic challenge[J]. Indian J Nucl Med, 2015, 30(1): 39−41. DOI: 10.4103/0972−3919.147534. [3] Szajewski M, Kruszewski WJ, Ciesielski M, et al. Primary osteosarcoma of the breast: A case report[J]. Oncol Lett, 2014, 7(6): 1962−1964. DOI: 10.3892/ol.2014.1981. [4] Dekkers IA, Cleven A, Lamb HJ, et al. Primary Osteosarcoma of the Breast[J]. Radiographics, 2019, 39(3): 626−629. DOI: 10.1148/rg.2019180181. [5] Mujtaba B, Nassar SM, Aslam R, et al. Primary Osteosarcoma of the Breast: Pathophysiology and Imaging Review[J]. Curr Probl Diagn Radiol, 2020, 49(2): 116−123. DOI: 10.1067/j.cpradiol.2019.01.001. [6] Mc Auley G, Jagannathan J, O'Regan K, et al. Extraskeletal Osteosarcoma: Spectrum of Imaging Findings[J]. AJR Am J Roentgenol, 2012, 198(1): W31−W37. DOI: 10.2214/AJR.11.6927. [7] Bahrami A, Resetkova E, Ro JY, et al. Primary osteosarcoma of the breast: report of 2 cases[J]. Arch Pathol LAb Med, 2007, 131(5): 792−795. DOI: 10.1043/1543−2165(2007)131[792:POOTBR]2.0.CO;2. [8] 杨先春, 左敏, 吴汉斌, 等. 原发性骨外骨肉瘤的影像诊断(附7例报道及文献复习)[J]. 影像诊断与介入放射学, 2018, 27(3): 226−231. DOI: 10.3969/j.issn.1005−8001.2018.03.010.
Yang XC, Zuo M, Wu HB, et al. Imaging diagnosis of primary extra-skeletal osteosarcoma: report of 7 cases[J]. Diagn Imaging Interv Radiol, 2018, 27(3): 226−231. DOI: 10.3969/j.issn.1005−8001.2018.03.010.[9] 银浩强, 钱孟超, 王嵩. 超声诊断乳腺原发性骨肉瘤1例[J]. 中国中西医结合影像学杂志, 2016, 14(5): 616−617. DOI: 10.3969/j.issn.1672−0512.2016.05.043.
Yin HQ, Qian MC, Wang S. Ultrasonic diagnosis of primary osteosarcoma of the breast: a case report[J]. Chin Imaging J Integr Tradit West Med, 2016, 14(5): 616−617. DOI: 10.3969/j.issn.1672−0512.2016.05.043.[10] 曾德春, 陈跃, 蔡亮, 等. 99Tcm-MDP全身骨显像异常骨外软组织摄取分析[J]. 重庆医学, 2016, 45(15): 2073−2074, 2077. DOI: 10.3969/j.issn.1671−8348.2016.15.013.
Zeng DC, Chen Y, Cai L, et al. Analysis of abnormal uptake of extraskeletal soft tissue in 99Tcm-MDP whole bone scan[J]. Chongqing Med, 2016, 45(15): 2073−2074, 2077. DOI: 10.3969/j.issn.1671−8348.2016.15.013.[11] 景红丽, 陈黎波, 李方, 等. 99Tcm-MDP骨显像发现骨外骨肉瘤腹腔多发转移灶一例[J]. 中华核医学杂志, 2003, 23(2): 97. DOI: 10.3760/cma.j.issn.2095−2848.2003.02.028.
Jing HL, Chen LB, Li F, et al. Multiple abdomen metastases of extraskeletal osteosarcoma were found by 99Tcm-MDP bone imaging: one case report[J]. Chin J Nucl Med, 2003, 23(2): 97. DOI: 10.3760/cma.j.issn.2095−2848.2003.02.028.[12] Soundararajan R, Naswa N, Sharma P, et al. SPECT-CT for characterization of extraosseous uptake of 99Tcm-methylene diphosphonate on bone scintigraphy[J]. Diagn Interv Radiol, 2013, 19(5): 405−410. DOI: 10.5152/dir.2013.054. [13] Zhang H, Guo LL, Tao WJ, et al. Comparison of the clinical application value of mo-targeted X-ray, color doppler ultrasound and MRI in preoperative comprehensive evaluation of breast cancer[J]. Saudi J Biol Sci, 2019, 26(8): 1973−1977. DOI: 10.1016/j.sjbs.2019.09.009. [14] Ciurea AI, Herţa HA, Iacoban CG, et al. Fibroadenomas and breast carcinoma: A possible answer to a frequently asked question[J]. Med Ultrason, 2018, 20(3): 385−391. DOI: 10.11152/mu−1408. [15] 吴建萍, 李鹍, 李卓琳, 等. 乳腺错构瘤X线、超声表现与病理11例病例并对照分析[J]. 昆明医科大学学报, 2015, 36(3): 95−98. DOI: 10.3969/j.issn.1003−4706.2015.03.025.
Wu JP, Li K, Li ZL, et al. Comparative Analysis on Mammography, Ultrasound and Pathology of Patients with Mammary Hamartoma[J]. J Kunming Med Univ, 2015, 36(3): 95−98. DOI: 10.3969/j.issn.1003−4706.2015.03.025.