Intra-articular primary malignant tumors:9 cases report

SHI Ying-bin; NIU Xiao-hui

doi:10.3969/j.issn.2095-252X.2014.02.004

Abstract：Objective To report 9 cases of intra-articular primary malignant tumors and to investigate the suitable diagnosis method and therapeutic scheme. Methods From August 2001 to July 2011, 9 patients with intra-articular primary malignant tumors were treated in our hospital. There were 6 men and 3 women with an average age of 43.8 years old ( range;21-76 years ). There were 7 cases of synovial sarcoma in the knee, 1 case of liposarcoma in the knee and 1 case of malignant diffuse-type tenosynovial giant cell tumors in the hip. The clinical features, image characteristics, diagnosis approaches and operative methods were retrospectively reviewed, and the postoperative joint function, side effects and prognoses were evaluated. Results All patients had pain in the joint before admission. The typical MRI features were low signal in T1 weighted images and high or mixed signal in T2 weighted images, which became enhanced markedly. The surgical treatment was performed on all the patients. The average follow-up period was 27.5 months ( range;12-60 months ), and the median follow-up period was 27 months. Four patients underwent amputation ifnally, and the other 5 patients had good joint function after the limb-salvage operation. Conclusions The incidence of intra-articular primary malignant tumors is low, and they may be easily misdiagnosed as benign tumors. The synovial sarcoma is the most common one in this group. Biopsy is needed before the operation to conifrm the diagnosis. The therapeutic scheme ( neoadjuvant chemotherapy or postoperative chemoradiotherapy ) can be made based on the pathological results, and the patients may had better prognoses. The joint involvement is evaluated according to the MRI images. The proper design of surgical margin may beneift the effective resection of tumors.