Ogino-Nishimura Eriko, Okamura Hiro-Oki, Kishimoto Seiji
Department of Head and Neck Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519 Tokyo, Japan.
Eur Arch Otorhinolaryngol. 2003 Sep;260(8):446-9. doi: 10.1007/s00405-003-0611-1. Epub 2003 Apr 16.
We describe the successful treatment of a fibromatosis (desmoid tumor) arising from the prevertebral fascia of the neck. Total resection with wide margins is reportedly the best treatment for this kind of tumor. However, the anatomy of the head and neck makes such resection difficult. In this case, we were unable to completely remove the tumor because it was large and located close to the cervical vertebrae, common carotid artery and internal jugular vein. Incomplete resection is known to result in higher tumor recurrence than complete resection. In addition, the recurrence or progression of a tumor in the head or neck region is known to cause mortality by compression of the airway or major blood vessels. On the basis of reports that irradiation is effective treatment for this kind of tumor, we administered 30-Gy irradiation to the affected area. This therapy was very effective and no sign of recurrence was seen for 2 years after irradiation. We found that function-sparing resection plus postoperative radiotherapy is an effective treatment for advanced fibromatosis in the head and neck regions with proximity to or involvement with vital structures.
我们描述了一例起源于颈部椎前筋膜的纤维瘤病（硬纤维瘤）的成功治疗案例。据报道，广泛切缘的完整切除是这类肿瘤的最佳治疗方法。然而，头颈部的解剖结构使得这种切除手术具有难度。在本病例中，由于肿瘤体积较大且位于颈椎、颈总动脉和颈内静脉附近，我们无法将肿瘤完全切除。已知不完全切除比完全切除导致肿瘤复发的几率更高。此外，头颈部区域肿瘤的复发或进展已知会因气道或主要血管受压而导致死亡。基于关于放射治疗对这类肿瘤有效的报道，我们对患区进行了30 Gy的放射治疗。该治疗非常有效，放疗后2年未见复发迹象。我们发现保留功能的切除加术后放疗是治疗头颈部区域靠近或累及重要结构的晚期纤维瘤病的有效方法。
