Diebels I, Blockhuys M, Willemsen P, Pirenne Y
a Department of General and Abdominal Surgery , ZNA Middelheim , Antwerp , Belgium.
b Faculty of Medicine and Health Sciences , University of Antwerp , Edegem , Belgium.
Acta Chir Belg. 2018 Jun;118(3):192-195. doi: 10.1080/00015458.2017.1341147. Epub 2017 Jun 22.
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.
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.
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.
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.
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。
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。
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。
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。
