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一例产后源于闭孔内肌的复发性硬纤维瘤自发消退病例。

A Case of Spontaneous Regression of Recurrent Desmoid Tumor Originating From the Internal Obturator Muscle After Delivery.

作者信息

Sueishi Takuya, Arizono Takeshi, Nishida Kenjiro, Hamada Takahiro, Inokuchi Akihiko

机构信息

Department of Orthopedic Surgery, Kyushu-Central Hospital, 23-1 Shiobaru 3-chome, Minami-ku, Fukuoka 815-8588, Japan.

出版信息

World J Oncol. 2016 Aug;7(4):75-80. doi: 10.14740/wjon963w. Epub 2016 Sep 3.

Abstract

Desmoid-type fibromatoses are pathologically benign but locally aggressive tumors. We report the case of a desmoid tumor that disappeared spontaneously after recurrence. A 21-year-old woman was referred to our hospital because of left lower limb weakness during menstruation. The following day this weakness had disappeared but menstrual colic remained; consequently, the patient underwent an internal examination that revealed an intrapelvic tumor. Magnetic resonance imaging demonstrated an enhanced mass (diameter, 8 cm) arising from the internal obturator muscle and attached to the urinary bladder. The tumor was diagnosed as a desmoid-type fibromatosis after histologic evaluation of a transvaginal biopsy; marginal resection was carried out at < 1 month after the first hospital admission. The patient experienced recurrence at 2 years after surgery, which was confirmed as two enhanced masses (diameter, 1 cm) using magnetic resonance imaging. Eleven months later, the diameters of these masses had increased to 1.8 cm; however, there was no further increase in size beyond this point. The patient delivered successfully at 5 and 7 years after surgery; at 8 years, the recurrent tumors had disappeared completely as confirmed by magnetic resonance imaging. This case involving recurrence is rare for two reasons. The first was that no change in the size of the tumors occurred during pregnancy and after delivery, and the second was that the patient experienced complete remission of the recurrent tumors after only simple observation. Thus, it is important to recognize that even a recurrent desmoid tumor can sometimes exhibit spontaneous regression.

摘要

韧带样型纤维瘤病是病理上良性但局部侵袭性的肿瘤。我们报告一例韧带样瘤复发后自发消失的病例。一名21岁女性因月经期间左下肢无力被转诊至我院。次日,这种无力感消失,但痛经仍存在;因此,患者接受了内诊检查,发现盆腔内有一个肿瘤。磁共振成像显示一个增强肿块(直径8 cm)起源于闭孔内肌并附着于膀胱。经阴道活检组织学评估后,该肿瘤被诊断为韧带样型纤维瘤病;首次入院后不到1个月进行了边缘切除术。患者术后2年复发,磁共振成像证实为两个增强肿块(直径1 cm)。11个月后,这些肿块直径增至1.8 cm;然而,此后大小未再进一步增大。患者术后5年和7年成功分娩;8年时,磁共振成像证实复发肿瘤已完全消失。该复发病例罕见有两个原因。一是肿瘤大小在孕期和产后均未发生变化,二是患者仅通过简单观察就出现复发肿瘤完全缓解。因此,重要的是要认识到,即使是复发的韧带样瘤有时也会出现自发消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcd4/5624703/95733895f7c8/wjon-07-075-g001.jpg

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