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一名患有多发性硬化症的女性患者腹直肌内大型进行性症状性硬纤维瘤的栓塞治疗:病例报告

Embolization of a large progressive symptomatic desmoid tumor in the rectus muscle of a female patient with multiple sclerosis: a case report.

作者信息

Diebels I, Blockhuys M, Willemsen P, Pirenne Y

机构信息

a Department of General and Abdominal Surgery , ZNA Middelheim , Antwerp , Belgium.

b Faculty of Medicine and Health Sciences , University of Antwerp , Edegem , Belgium.

出版信息

Acta Chir Belg. 2018 Jun;118(3):192-195. doi: 10.1080/00015458.2017.1341147. Epub 2017 Jun 22.

Abstract

INTRODUCTION

Desmoid tumors are benign tumors, yet can lead to significant morbidity due to aggressive local expansions. Treatment starts with a wait-and-see policy, however, more aggressive treatments like broad margin resection surgery might be necessary in case of tumor progression.

PATIENTS AND METHODS

We report the case of a 26-year-old female with a symptomatic desmoid tumor in the left rectus muscle. The initial wait-and-see policy led to an increase in tumor size and progression of symptoms. Computed tomography (CT) angiography revealed a dominant arterial blood supply via a branch of the inferior epigastric artery. We then performed a super selective embolization of the dominant arterial blood supply, to avoid the need for broad margin resection.

RESULTS

At three months follow-up, the patient was asymptomatic and magnetic resonance imaging (MRI) showed no residual tumor. At nine months follow-up, MRI scan reconfirmed the successful outcome.

CONCLUSIONS

Embolization of a primary supplying vessel of a desmoid tumor is a viable treatment option. However, scientific evidence remains limited and further research is mandatory for inclusion in evidence based treatment algorithms.

摘要

引言

硬纤维瘤是良性肿瘤,但因其侵袭性局部扩张可导致严重的发病率。治疗首先采取观察等待策略,然而,在肿瘤进展的情况下,可能需要更积极的治疗,如广泛边缘切除手术。

患者与方法

我们报告一例26岁女性,左直肌有症状性硬纤维瘤。最初的观察等待策略导致肿瘤大小增加和症状进展。计算机断层扫描(CT)血管造影显示通过腹壁下动脉分支有主要动脉血供。然后我们对主要动脉血供进行了超选择性栓塞,以避免进行广泛边缘切除。

结果

在三个月的随访中,患者无症状,磁共振成像(MRI)显示无残留肿瘤。在九个月的随访中,MRI扫描再次证实了成功的结果。

结论

栓塞硬纤维瘤的主要供血血管是一种可行的治疗选择。然而,科学证据仍然有限,必须进行进一步研究以纳入基于证据的治疗算法。

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