Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 11: 1470 - 1477

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.11.010

Clinical research

Surgical approach and prognosis evaluation of primary benign and aggressive bone tumors involving the acetabulum

  • Zhu-sheng ZHANG ,
  • Qi LIU ,
  • Qi-yuan BAO ,
  • Yu-hui SHEN ,
  • Wei-bin ZHANG ,
  • Rong WAN
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  • Department of Orthopaedic, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
WAN Rong, E-mail: rongww@hotmail.com.

Online published: 2021-12-03

Supported by

Foundation from Chinese Society of Clinical Oncology(Y-HR2019-0442)

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Abstract

Objective

·To summarize the general characteristics, management principles and prognosis of benign and aggressive bone tumors (BABT) involving the acetabulum.

Methods

·A total of 88 cases of primary acetabular lesions were collected, including 41 cases of BABTs. The demographic data of the patients, the surgical procedures and the prognosis of the patients were analyzed.

Results

·The median follow-up time of the 41 cases of BABTs was 42.6 months. Lesion curettage with bone grafting was performed in 30 cases, followed by curettage with cement reconstruction (n=2), enbloc resection with endoprosthesis reconstruction (n=8), and hemi-pelvic amputation (n=1). Postoperative pathology confirmed a benign tumor in 23 cases, 8 of which were accompanied by bone cortical damage (34.8%), and only 2 patients had local recurrence. Postoperative pathology demonstrated an aggressive histology in 18 cases, 14 cases of which were accompanied by bone cortical damage (77.8%), and a total of 5 cases had local recurrence. Of the 7 giant cell tumors of bone, one recurred (14.3%), in comparison to 3 local recurrence (75.0%) of the 4 cases of atypical cartilage hyperplasia.

Conclusion

·Benign acetabular tumors without cortical bone damage have a low recurrence rate following lesion curettage. Aggressive tumors and/or tumors with cortical bone damage have a higher recurrence rate following simple curettage, and the surgical margin needs to be strictly determined prior to surgery. Specifically, lesion curettage with bone cement or enbloc resection with endoprosthesis reconstruction could be an appropriate option for giant cell tumor of bone, while enbloc resection with endoprosthesis reconstruction should be always recommended for atypical cartilage tumor.

Key words： acetabular; benign and aggressive bone tumors (BABT); surgery methods; prognostic factors

Cite this article

Zhu-sheng ZHANG , Qi LIU , Qi-yuan BAO , Yu-hui SHEN , Wei-bin ZHANG , Rong WAN . Surgical approach and prognosis evaluation of primary benign and aggressive bone tumors involving the acetabulum[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(11) : 1470 -1477 . DOI: 10.3969/j.issn.1674-8115.2021.11.010

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