Background/Objectives: Atypical cartilaginous tumours (ACTs) are intermediate, locally aggressive chondroid tumours in the appendicular skeleton. Due to the potential for transformation into high-grade chondrosarcomas, management typically consists of regular MRI follow-up and, occasionally, surgery. We primarily aimed to examine the rate of malignant transformation in ACTs in our hospital; secondarily, we aimed to identify the factors influencing management choices and outcomes.Methods: All patients referred between 2013 and 2020 with a long-bone ACT were identified from the unit database. For this retrospective study, we analysed the imaging, management, and outcomes for the patients discussed at our musculoskeletal radiological conference.Results: A total of 59 patients were included; of these, 0 cases of malignant transformation were observed with a mean follow-up time of 8.4 years. Of the presenting cases, the musculoskeletal radiological conference advised that 6 should be biopsied, 40 should receive MRI follow-up, 7 should receive X-ray follow-up, and 6 should be re-examined in clinic. Subsequently, 12 patients underwent surgery due to continued pain, diagnostic uncertainty, and historical practices. Of these, seven experienced continued post-operative pain.Conclusions: None of the encountered ACTs underwent malignant transformation, supporting previous findings that this transformation is a rare phenomenon. Furthermore, of the small sample of patients undergoing surgery, less than half were left pain-free. These findings support a more conservative approach to ACT management, with the potential to discharge after an initial review.
背景/目的：非典型软骨性肿瘤（ACTs）是四肢骨骼中具有局部侵袭性的中间型软骨样肿瘤。由于存在转化为高级别软骨肉瘤的潜在风险，其处理通常包括定期MRI随访，偶尔进行手术。本研究主要旨在探讨我院ACTs的恶性转化率；次要目的是识别影响治疗选择及预后的相关因素。 方法：通过科室数据库检索2013年至2020年间所有被诊断为长骨ACTs的患者。在这项回顾性研究中，我们分析了在肌肉骨骼放射学会议上讨论的患者的影像学资料、治疗方案及临床结局。 结果：共纳入59例患者，平均随访时间8.4年，期间未观察到恶性转化病例。在提交讨论的病例中，肌肉骨骼放射学会议建议：6例应进行活检，40例应接受MRI随访，7例应接受X线随访，6例需门诊复查。后续有12例患者因持续疼痛、诊断不明确及既往诊疗惯例接受了手术治疗，其中7例术后仍存在持续性疼痛。 结论：本研究中所有ACTs病例均未发生恶性转化，这支持了既往研究关于此类转化罕见性的结论。此外，在接受手术治疗的小样本患者中，仅不足半数获得疼痛缓解。这些发现支持对ACTs采取更保守的治疗策略，并提示在初次评估后存在让患者结束随访的可能性。
Transformation and Management of Long-Bone Atypical Cartilaginous Tumours
肿瘤(癌症)患者之家