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肛门外括约肌低度恶性纤维黏液样肉瘤:一例报告

Low-grade fibromyxoid sarcoma of the external anal sphincter: a case report.

作者信息

Ban Lee-Kiat, Tseng Ailun Heather, Huang Shih-Hung, Lee Henry Hsin-Chung

机构信息

Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan.

College of Medical Technology, Nursing and Wellbeing, Yuanpei University of Medical Technology, Yuanpei Street, Hsinchu, Taiwan.

出版信息

World J Surg Oncol. 2017 May 30;15(1):109. doi: 10.1186/s12957-017-1174-8.

Abstract

BACKGROUND

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor that has a tendency to grow in the deep soft tissue of the trunk and extremities. Despite its benign appearance, the tumor has a high recurrence rate and metastatic potential. LGFMS in the perineal space is rare, and only a few cases have been reported. We present the first case of LGFMS to be located at the external anal sphincter.

CASE PRESENTATION

A 27-year-old male patient admitted to our Surgical Department with perianal pain and swollen for a year. The digital rectal examination revealed a perianal mass. Oral metronidazole and analgesia were prescribed on suspicion of perianal abscess failed to alleviate the symptom; hence, the patient was scheduled for surgery. Intraoperative diagnosis revealed an encapsulated tumor in the external anal sphincter that extended from the perianal region orally to the pararectal space. The results of immunohistochemistry (MUC4 staining) and FUS gene rearrangement by fluorescence in situ hybridization confirmed the diagnosis of LGFMS.

CONCLUSIONS

This case is unique in terms of the location of the rare soft tissue tumor. Although LGFMS is considered low grade, its unpredictable behavior necessitates a long-term follow-up.

摘要

背景

低度纤维黏液样肉瘤(LGFMS)是一种罕见的软组织肿瘤,倾向于在躯干和四肢的深部软组织中生长。尽管其外观为良性,但该肿瘤具有较高的复发率和转移潜能。会阴间隙的LGFMS较为罕见,仅有少数病例报道。我们报告首例位于肛门外括约肌的LGFMS。

病例介绍

一名27岁男性患者因肛周疼痛和肿胀1年入住我院外科。直肠指检发现肛周肿物。因怀疑肛周脓肿给予口服甲硝唑和止痛治疗,但症状未缓解;因此,患者被安排手术。术中诊断为肛门外括约肌的一个包膜完整的肿瘤,从肛周区域向口侧延伸至直肠旁间隙。免疫组织化学(MUC4染色)结果和荧光原位杂交检测FUS基因重排证实了LGFMS的诊断。

结论

就这种罕见软组织肿瘤的位置而言,本病例具有独特性。尽管LGFMS被认为是低度恶性,但因其行为不可预测,需要长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec62/5450221/c7930f048925/12957_2017_1174_Fig1_HTML.jpg

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