Mathew David, George Reena Mary, Jeba Jenifer, Varghese Sunita Susan
Palliative Care Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
Indian J Palliat Care. 2011 Sep;17(3):245-7. doi: 10.4103/0973-1075.92349.
Desmoid fibromatosis, although histologically benign, infiltrates local structures. The involvement of neural structures can lead to difficult neuropathic pain and the escalating use of analgesics. We report a patient with desmoid fibromatosis of the chest wall causing brachial plexus infiltration. As the tumor was locally invasive and unresectable, he was treated with radiation therapy and oral tamoxifen. On follow-up, there was significant pain relief, sustained reduction in the tumor size, and reduced analgesic requirement. Antineoplastic treatments like local radiation therapy and targeted systemic therapy with hormones or other agents can be considered in the management of selected unresectable desmoid fibromatosis to improve symptom control and reduce polypharmacy.
硬纤维瘤病虽然组织学上为良性,但会浸润局部结构。神经结构受累可导致难治性神经性疼痛以及镇痛药物使用的不断增加。我们报告一例胸壁硬纤维瘤病导致臂丛神经浸润的患者。由于肿瘤具有局部侵袭性且无法切除,对其采用了放射治疗和口服他莫昔芬治疗。随访时,患者疼痛明显缓解,肿瘤大小持续缩小,镇痛药物需求减少。对于部分无法切除的硬纤维瘤病,在治疗中可考虑采用局部放射治疗以及激素或其他药物的靶向全身治疗等抗肿瘤治疗方法,以改善症状控制并减少联合用药。