Çelik Serkan Yaşar, Dere Yelda, Çelik Özgür İlhan, Derin Serhan, Şahan Murat, Dere Özcan
Department of Pathology, Faculty of Medicine, Mugla Sıtkı Kocman University, Muğla, Turkey.
Department of Otorhinolaryngology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
Oman Med J. 2017 Jan;32(1):69-72. doi: 10.5001/omj.2017.13.
Nodular fasciitis is a benign, reactive, tumor-like lesion composed of fibroblasts and myofibroblasts. It typically occurs in the extremities and the trunk. Head and neck localization is 13-20%. As it grows rapidly, clinicians frequently misdiagnose it as an aggressive or a malignant lesion. Some lesions show moderate cellularity, mild cellular atypia, and mitosis histologically causing pathologists to over-diagnose the lesion as a malignant tumor. It is important to diagnose nodular fasciitis correctly to avoid unnecessary additional surgery and treatment. We report the case of an 82-year-old woman who was admitted to the emergency department with a one-month history of progressive shortness of breath. We found a mass in the patient's neck, invasive to the trachea, which was the cause of her symptom. Complete radical surgery of the mass with the larynx was impossible due to her general status. The mass was treated by local radiotherapy; however, no regression was seen in the size of the mass. The patient is still on follow-up with only symptomatic medical support for airway obstruction.
结节性筋膜炎是一种由成纤维细胞和肌成纤维细胞组成的良性、反应性、肿瘤样病变。它通常发生在四肢和躯干。头颈部受累占13 - 20%。由于其生长迅速，临床医生常将其误诊为侵袭性或恶性病变。一些病变在组织学上表现为细胞中度增多、轻度细胞异型性和核分裂象，导致病理学家将病变过度诊断为恶性肿瘤。正确诊断结节性筋膜炎对于避免不必要的额外手术和治疗很重要。我们报告一例82岁女性患者，因进行性气短1个月入住急诊科。我们在患者颈部发现一个肿块，侵犯气管，这是她症状的原因。由于患者的一般状况，无法对肿块连同喉部进行完全根治性手术。对肿块进行了局部放疗；然而，肿块大小未见缩小。患者仍在接受随访，仅对气道阻塞进行对症医疗支持。
