Allen P J, Shriver C D
Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Semin Thorac Cardiovasc Surg. 1999 Jul;11(3):264-9. doi: 10.1016/s1043-0679(99)70067-5.
Desmoid tumors are rare soft tissue neoplasms derived from fascial or musculoaponeurotic structures. These tumors are histologically benign but may behave aggressively at the local level with multiple recurrences after complete resection being common. Chest wall desmoids account for approximately 20% of all patients with desmoid tumors. Patients with these lesions are often asymptomatic and thus commonly present with lesions greater than 10 cm in size. The treatment for these neoplasms remains margin negative surgical excision, and, given the often large size at presentation, may require extensive chest wall resection. When this is required, chest wall reconstruction with either prosthetic material and/or autologous tissue may be performed. There may be recurrence in as many as 75% of patients. Neither adjuvant radiotherapy or chemotherapy have been shown to reduce the rate of recurrence. Recurrence should also be treated with surgical resection because patients who undergo complete surgical resection of recurrence are as likely to remain disease free after resection as patients who present with primary disease.
硬纤维瘤是一种罕见的软组织肿瘤，起源于筋膜或肌-腱膜结构。这些肿瘤在组织学上是良性的，但在局部可能具有侵袭性，完全切除后多次复发很常见。胸壁硬纤维瘤约占所有硬纤维瘤患者的20%。这些病变的患者通常无症状，因此通常表现为大小超过10厘米的病变。这些肿瘤的治疗仍然是切缘阴性的手术切除，并且由于就诊时肿瘤通常较大，可能需要广泛的胸壁切除。当需要进行胸壁切除时，可以使用假体材料和/或自体组织进行胸壁重建。多达75%的患者可能会复发。辅助放疗或化疗均未显示能降低复发率。复发也应采用手术切除治疗，因为接受复发病灶完全手术切除的患者与原发性疾病患者一样，切除后无病生存的可能性相同。
