Okitsu H, Tsuboi M, Nakajima S, Takahashi E, Hakoshima A, Ishimaru S
Department of Surgery, Tokyo Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Sep;38(9):1506-10.
Fibromatosis is rare and locally invasive tumor arising from musculoaponeurotic tissue, and also has a high postoperative recurrence rate. So, we must perform wide resection of the tumor and surrounding tissue. A case of fibromatosis originating from the right anterior scalene muscle was reported. A 31-year-old female in whom cervical fibromatosis had been pointed out by her home doctor, was referred to our hospital for treatment. CT scan, MRI and angiography showed that the tumor developed from the cervical lesion to the upper thoracic and invaded the right subclavian artery. The tumor originating from right anterior scalene muscle was found at operation. The combined resection consisted of the right anterior salene muscle with tumor, phrenic nerve, subclavian artery and vein, and chest, well including the first and second rib and clavicular bone, because of wide invasion of tumor to surrounding organs. Reconstruction of the subclavian artery and vein was performed by PTFE vascular prostheses. The postoperative course was uneventful, she is now in good health 8 months after operation with good blood flow via the reconstructed vessels confirmed by angiography, without any sign of recurrence.
纤维瘤病是一种罕见的、起源于肌筋膜组织的局部侵袭性肿瘤，术后复发率也很高。因此，我们必须对肿瘤及其周围组织进行广泛切除。本文报告了一例起源于右侧前斜角肌的纤维瘤病病例。一名31岁女性，其家庭医生已指出患有颈部纤维瘤病，被转诊至我院接受治疗。CT扫描、MRI和血管造影显示，肿瘤从颈部病变发展至胸上段，并侵犯了右锁骨下动脉。手术中发现肿瘤起源于右侧前斜角肌。由于肿瘤广泛侵犯周围器官，联合切除包括右侧前斜角肌及其肿瘤、膈神经、锁骨下动静脉以及胸廓，还包括第一和第二肋骨及锁骨。采用聚四氟乙烯血管假体对锁骨下动静脉进行重建。术后过程顺利，术后8个月她目前身体健康，血管造影证实重建血管血流良好，无任何复发迹象。
