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[1例经术前动脉栓塞成功切除的眶内孤立性纤维瘤]

[A case of intraorbital solitary fibrous tumor resected successfully with preoperative arterial embolization].

作者信息

Kishimoto Ippei, Shinohara Shogo, Fujiwara Keizo, Kikuchi Masahiro, Tona Risa, Kanazawa Yuji, Harada Hiroyuki, Naito Yasushi, Usami Yu

出版信息

Nihon Jibiinkoka Gakkai Kaiho. 2014 Dec;117(12):1477-82. doi: 10.3950/jibiinkoka.117.1477.

Abstract

The solitary fibrous tumor (SFT) is a rare spindle cell neoplasm derived from mesenchymal cells. It sometimes recurs clinically, and is categorized as an 'intermediate malignancy' tumor under the WHO (World Health Organization) classification of soft tissue tumors. Several studies have reported on intraorbital SFTs, but none of them has pointed out the utility of preoperative arterial embolization in the case of an intraorbital SFT. A 75-year-old man, who had received a dacryocystectomy for a benign tumor in the right lacrimal sac 30 years previously, visited our hospital complaining of lower eyelid swelling and lachrymation that had persisted for a year. CT and MRI revealed an intraorbital lesion, and the open biopsy specimen showed dense growth of spindle cells, which turned out to be an SFT by immunohistochemistry based on the findings. After preoperative embolization of the infraorbital artery, we removed the tumor with a skin incision on the lower rim of the orbit with little bleeding. The surgical specimen revealed that the tumor was close to a lacrimal canaliculus, which suggested the tumor originated from the lacrimal apparatus considering the patient's past history. He was followed up for three months without recurrences.

摘要

孤立性纤维瘤(SFT)是一种罕见的源自间充质细胞的梭形细胞瘤。它有时会在临床上复发,在世界卫生组织(WHO)软组织肿瘤分类中被归类为“中间型恶性”肿瘤。已有多项关于眶内SFT的研究报道,但均未指出术前动脉栓塞在眶内SFT病例中的作用。一名75岁男性,30年前因右侧泪囊良性肿瘤接受了泪囊切除术,因下眼睑肿胀和流泪持续一年前来我院就诊。CT和MRI显示眶内有病变,开放活检标本显示梭形细胞密集生长,根据检查结果通过免疫组织化学证实为SFT。在对眶下动脉进行术前栓塞后,我们通过眼眶下缘的皮肤切口切除肿瘤,术中出血很少。手术标本显示肿瘤靠近泪小管,考虑到患者的既往病史,提示肿瘤起源于泪器。对他进行了三个月的随访,未见复发。

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