Academic Section of Vascular Surgery, Imperial College London, London, UK,
Hernia. 2014 Feb;18(1):91-7. doi: 10.1007/s10029-013-1156-x. Epub 2013 Sep 17.
An abdominal mass is a common clinical presentation, and a small percentage of such patients will have an abdominal wall tumour with the two most common pathologies being fibromatosis and soft tissue sarcoma.
Here we present the available literature on the diagnosis and management of both fibromatosis and soft tissue sarcoma, in the context of our experience in a tertiary referral centre for sarcoma.
Appropriate cross-sectional imaging and a pre-operative tissue diagnosis by percutaneous core biopsy are necessary to define management. Desmoid fibromatosis can be managed initially by observation with serial imaging, with surgery being reserved for those patients who demonstrate progression. Soft tissue sarcoma can display a range of pathologies from relatively indolent tumours to locally aggressive sarcomas that can readily metastasise. An accurate pre-operative histological diagnosis and staging enables a multidisciplinary approach to management. This may include chemotherapy and radiotherapy, but the mainstay of treatment remains wide surgical resection and abdominal wall reconstruction. Patient outcomes are worse if referral is delayed or if the sarcoma is incompletely resected without an initial tissue diagnosis.
腹部肿块是一种常见的临床症状，其中一小部分患者将患有腹壁肿瘤，两种最常见的病理类型是纤维瘤病和软组织肉瘤。
在这里，我们根据我们在肉瘤三级转诊中心的经验，介绍了纤维瘤病和软组织肉瘤的诊断和治疗的现有文献。
适当的横断面成像和术前经皮核心活检的组织诊断对于明确管理是必要的。对于那些表现出进展的患者，可以保留手术治疗。软组织肉瘤可以表现出一系列从相对惰性肿瘤到局部侵袭性肉瘤的病理类型，这些肿瘤很容易转移。准确的术前组织学诊断和分期可以实现多学科管理。这可能包括化疗和放疗，但主要的治疗方法仍然是广泛的手术切除和腹壁重建。如果延迟转诊或在没有初始组织诊断的情况下不完全切除肉瘤，患者的预后会更差。
