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急性创伤促使胸壁黏液纤维肉瘤发病

Acute Trauma Precipitating the Onset of Chest Wall Myxofibrosarcoma.

作者信息

Klingbeil Kyle D, Vangara Sameera S, Fertig Raymond M, Radick Jason L

机构信息

1Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136 USA.

2Department of Surgery, University of Miami Miller School of Medicine, Clinical Research Building, 1120 N.W. 14th St., Miami, FL 33136 USA.

出版信息

Indian J Surg Oncol. 2018 Sep;9(3):411-413. doi: 10.1007/s13193-018-0768-0. Epub 2018 Jun 20.

Abstract

A previously healthy, 47-year-old male presented to his primary care physician with the complaint of a nontender, palpable breast mass discovered coincidentally 1 month after being scratched in the same location by his pet cat. Family history revealed his father was diagnosed with a soft tissue sarcoma of the thigh, 6 months following a traumatic injury in the same location. Cat scratch disease was considered; however, antibody testing was negative. Imaging studies revealed a subpectoral mass without rib involvement. Subsequent core biopsy revealed malignant fibrous histiocytoma, myxoid type, also known as myxofibrosarcoma. The patient underwent complete surgical resection with no complications. Medical advice recommended adjuvant radiation therapy due to the high risk of recurrence; however, the patient refused this option. Twenty-five months later, the patient remains in remission and in overall good health. This case describes the development of a chest wall tumor, diagnosed as myxofibrosarcoma, following acute trauma to the area. The association between acute traumatic injury and the development of a soft tissue sarcoma, as described in this case, continues to be widely reported, suggesting the possibility for an underlying causal mechanism. Future studies are required to unravel the pathogenesis in order to advance the management of this disease.

摘要

一名47岁的男性,既往身体健康,因在被宠物猫抓伤同一部位1个月后偶然发现一个无痛性、可触及的乳腺肿块,前来初级保健医生处就诊。家族史显示,他的父亲在同一部位遭受创伤6个月后,被诊断为大腿软组织肉瘤。考虑过猫抓病;然而,抗体检测呈阴性。影像学检查显示胸肌下有一个肿块,未累及肋骨。随后的核心活检显示为黏液样恶性纤维组织细胞瘤,也称为黏液纤维肉瘤。患者接受了完整的手术切除,无并发症。由于复发风险高,医疗建议推荐辅助放疗;然而,患者拒绝了这一选择。25个月后,患者仍处于缓解期,总体健康状况良好。本病例描述了该区域急性创伤后胸壁肿瘤(诊断为黏液纤维肉瘤)的发生情况。如本病例所述,急性创伤性损伤与软组织肉瘤发生之间的关联仍有广泛报道,提示可能存在潜在的因果机制。需要进一步研究以阐明发病机制,从而改进该疾病的治疗。

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