Arteau Annie, Seeli Franziska, Fuchs Bruno
Hôtel Dieu de Québec, 11 Côte du Palais, Quebec, G1R 2J6, Canada.
Sarkomzentrum UZH, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland.
J Med Case Rep. 2017 Jan 14;11(1):13. doi: 10.1186/s13256-016-1132-z.
Musculoskeletal tumors involving the deltoid muscle and necessitating its complete resection are rare. The function after complete deltoid resection is reported to be limited, and several authors consider muscle transfer to improve shoulder motion. However, it still remains unclear whether such transfer adds function. To the best of our knowledge, all reports on complete deltoid resection refer to adult patients, and it is unknown what function results after deltoid resection in childhood. The remaining muscles may have the potential to compensate for the loss of deltoid function.
Here we report the case of a 5-year-old white boy with complete (isolated) deltoid muscle resection in infancy for a large aggressive soft tissue tumor. No reconstructive procedure or muscle transfer was performed at the time of index surgery. Pathology revealed an angiomatoid fibrous histiocytoma. His postoperative course was uneventful. At 11 years of follow-up, he remained disease-free and had excellent shoulder function, including normal range of motion.
This report implies that major muscles such as the deltoid can be resected in a child without compromising long-term function. Therefore, a muscle transfer at index surgery is probably not necessary.
累及三角肌并需要将其完全切除的肌肉骨骼肿瘤较为罕见。据报道，三角肌完全切除后的功能有限，一些作者认为肌肉转移可改善肩部活动。然而，这种转移是否能增加功能仍不明确。据我们所知，所有关于三角肌完全切除的报道均涉及成年患者，儿童期三角肌切除后的功能结果尚不清楚。其余肌肉可能有潜力代偿三角肌功能的丧失。
在此，我们报告一名5岁白人男孩的病例，其在婴儿期因巨大侵袭性软组织肿瘤接受了三角肌完全（孤立）切除。初次手术时未进行重建手术或肌肉转移。病理显示为血管瘤样纤维组织细胞瘤。他的术后过程顺利。随访11年时，他无疾病复发，肩部功能良好，包括活动范围正常。
本报告表明，儿童期可以切除如三角肌这样的主要肌肉而不影响长期功能。因此，初次手术时可能无需进行肌肉转移。
