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小骨発生の骨巨細胞腫11例の臨床病理学的特徴について検討した.約半数が20歳以下の発症で,若年発症の傾向がみられた.画像上,骨皮質の著明な膨隆が特徴的であった.再発2例,肺転移1例が認められ,初回手術にen block切除以上の手術が5例存在することから,小骨発生の巨細胞腫の活動性の高さが示唆された.P63免疫染色は骨巨細胞腫と巨細胞修復性肉芽腫との鑑別に有用であることに加え,陽性細胞数,染色性の強度は,予後予測因子としての価値を持つ可能性も示唆された.
Clinicopathological features of 11 cases of giant cell tumors of small bones were investigated. Giant cell tumor in small bones were seen in younger patients compared to those in large bones, with about half arising in patients under 20 years old. Excessive expansion of the cortical bone was a special feature. There were 2 cases of recurrence and one case of lung metastasis.
Giant cell tumor of small bones may have more aggressive behavior evidenced by 5 cases requiring en block resections or amputation as a primary surgery. The immunohistochemistry of p63 may be useful for differential diagnosis from giant cell reparative granuloma, in addition, the number of positive cells and there intensity may have value as a prognostic factor.
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