Bone hemangioendothelioma
Introduction
Introduction to bone vascular endothelial cell tumor In 1943, Stout named a malignant vascular tumor as a vascular endothelial cell tumor. Later, it was very confusing in histological classification and naming. Many names have been used, and it has been gradually unified, called bone vascular endothelial cell tumor. It is recognized that bone vascular endothelial cell tumor is an intermediate or unshaped tumor between bone hemangioma and osteosarcoma, which is a good or malignant tumor. It is a low-malignant tumor that diffuses infiltration but does not metastasize. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: fracture
Cause
Cause of bone vascular endothelial cell tumor
(1) Causes of the disease
The cause is unknown.
(two) pathogenesis
Macroscopic observation of the tumor purple red or brown red, the tumor is unclear, no capsule, infiltration into the adjacent cortical bone, bone hyperplasia is not obvious.
Under the microscope, the endothelial cells proliferated actively, the cells were obviously obese, and there were more mitotic phases. The vascular cavity was filled with proliferating endothelial cells, showing solid cell lines or only a small lumen, lacking clear malignant histology. feature.
Prevention
Osteovascular endothelial cell tumor prevention
Preventing the occurrence of tumors is the key to preventing this disease. Tumor prevention refers to reducing the mortality of tumors by reducing the incidence of tumors. Specifically, it aims to prevent tumor infection-related infectious factors, change unhealthy lifestyles, exercise properly, maintain a happy spirit, and use certain medical interventions to reduce tumors by targeting a variety of environmental cancer risk factors. Risk of onset.
Complication
Bone vascular endothelial cell tumor complications Complications
Tumor-affected tumors compress the spinal cord or spinal nerve roots to cause neurological symptoms and paralysis, and a few can be associated with rational fractures.
Symptom
Symptoms of bone vascular endothelial cell tumor Common symptoms Dull pain Growth slow bone cyst
The literature reports that the age distribution is 10 to 75 years old, the average male is 32 years old, and the female is 43 years old. The incidence of males is more than that of females. Most of the lesions are single, but there are also multiple lesions. The most vertebrae are the parts, and the rest are tibia and femur. The humerus, pelvis, ribs, jaws, etc. can also occur in the hands and feet.
Symptoms and signs: slow onset, often asymptomatic, ranging from a few weeks to several years, an average of 5 months, early symptoms are mild, mainly manifested as local dull pain, tenderness and swelling, slowly aggravating, swelling gradually obvious, approaching The lesions of the joints can cause joint activity limitation. The tumor bones can be oppressed and the spinal cord or spinal nerve roots can cause nervous system symptoms and paralysis. The lesions continue to develop, the bone destruction is intensified, and the cortical bone is broken, forming a soft tissue mass. Large, tender, increased skin temperature, a small number of pathological fractures.
Examine
Examination of bone vascular endothelial cell tumor
It tends to be dry and has few backbones. It mainly manifests in flaky or irregular osteolytic destruction. In the damaged area, residual trabecular bone can be seen. The edges are clear or fuzzy, sometimes foamy and osteolytic. Radial bone needles may be perpendicular to the bone around the tumor bone, or may be cluster-like or staggered, a few have periosteal reactions, no ossification and calcification in the soft tissue mass, diffuse swelling in the border is unclear, spinal lesions, often infringed One or more vertebral bodies can destroy the compression and wedge shape, and can also invade the vertebral arch.
Arterial angiography clearly shows most of the bone destruction and the increased density and abnormal vascular shadow of the tumor deep into the soft tissue.
Diagnosis
Diagnosis and diagnosis of bone vascular endothelial cell tumor
diagnosis
According to the onset of illness, often asymptomatic, long course of disease, early symptoms are local dull pain and tenderness, slowly aggravating, swelling, limited mobility, neurological symptoms and spasm of spinal lesions, and then soft tissue mass, X-ray film found dry There are lamellae, foamy or irregular osteolytic destruction, radial bone needle around the tumor bone, no calcification and ossification in the soft tissue mass, clinically excluded osteolytic sarcoma, metastatic cancer, malignant lymphoma and myeloma After that, the possibility of osteovascular endothelial cell tumor should be considered. If the biopsy is found to be a soft red tumor of purplish red or brownish red blood clot, the vascular endothelial cells proliferate actively under the microscope, and the proliferating endothelial cells fill the vascular cavity. It is a solid cell cord with no definite malignant features. It can be diagnosed as vascular endothelial cells after differentiation from aneurysmal bone cyst, metastatic carcinoma, epithelioid hemangioma, angiosarcoma and pigmented villonodular synovitis. tumor.
Differential diagnosis
In the diagnosis of this disease, attention should be paid to the differentiation of aneurysmal bone cyst, metastatic carcinoma epithelioid hemangioma, angiosarcoma and pigmented villonodular synovitis.
