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[胸壁硬纤维瘤——恶性肿瘤的重要鉴别诊断]

[Desmoid tumor of chest wall--an important differential diagnosis to malignancies].

作者信息

Oddsson Saemundur J, Kristvinsson Hoeskuldur, Jónasson Jón Gunnlaugur, Torfason Bjarni, Gudbjartsson Tómas

出版信息

Laeknabladid. 2006 Nov;92(11):777-80.

Abstract

Desmoid tumors are rare solid tumors that arise from musculoaponeurotic tissues. They are classified as benign as they do not metastasize. Desmoid tumors can, however, exhibit rapid local growth and clinically they can mimic sarcomas. Their histological appearance can also resemble some malignant neoplasms such as low grade sarcomas, rendering the differential diagnosis difficult. The present report describes a 60-year-old woman with a history of left mastectomy, performed for a lymph node negative adenocarcinoma. At follow-up 4 years later, a solid nodule was palpated below the right breast. The tumor increased in size over several weeks and caused local radiating chest pain. Clinically a breast cancer metastasis was suspected. Open biopsy revealed a desmoid tumor. The tumor was resected together with a part of the anterior hemithorax, and the defect in the chest wall covered with a Goretex-patch. Six months postoperatively, the patient is doing well with no signs of locally recurrent disease.

摘要

硬纤维瘤是一种罕见的实性肿瘤,起源于肌筋膜组织。它们被归类为良性肿瘤,因为不会发生转移。然而,硬纤维瘤可表现出局部快速生长,在临床上可类似肉瘤。其组织学表现也可能类似于一些恶性肿瘤,如低级别肉瘤,这使得鉴别诊断很困难。本报告描述了一名60岁女性,有左侧乳房切除术史,该手术是因淋巴结阴性腺癌而进行的。4年后随访时,在右乳房下方触及一个实性结节。肿瘤在数周内增大,并引起局部放射性胸痛。临床上怀疑是乳腺癌转移。开放活检显示为硬纤维瘤。肿瘤连同部分前半胸被切除,胸壁缺损用戈尔特斯补片覆盖。术后6个月,患者情况良好,无局部复发疾病迹象。

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