広範切除術を行った軟骨肉腫の２例

Abstract

We experienced 2 cases of chondrosarcoma treated by wide local resection. Case 1, a 49 year-old woman, had a mass with a history of tumor formation for 5 or 6 years in the right 2nd and 3rd intermetacarpal region, which had been resected 20 years previously. This case was a very rare secondary chondrosarcoma (Grade 1 in Evans' classification) originating from the 3rd metacarpal bone. She survives relapse-free without any limitation of ADL except for inability to use chopsticks at 30 months after wide local resection with a marginal margin.Case 2, a 46 year-old woman, had noticed tumor formation in her right thigh for 2 or 3 years. Roentgenographically the tumor was located from the femoral neck through to the mid-distal one third of the femoral shaft, and showed a ground glass appearance with a partial central radiolucent area and a thicker cortex. This case was diagnosed as pimary central chondrosarcoma (Grade 2 in Evans' classification). She has survived relapse-free, graded by Enneking's modified functional evaluation method as “Good” (25points) in the knee joint and “Fair” (20points) in hip joint 20months after wide local resection with a wide margin followed by total femoral replacement with a Kotz modular femur and tibia reconstruction system.Although she developed an allergic skin reaction to metal around the surgical scar at the knee joint 13 months after surgery, this completely disappeared with steroid ointment. No loosening has been seen.