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腹壁成形术后复发并向腹腔内扩展的硬纤维瘤:一种罕见的表现。

Recurrent Desmoid Tumor with Intra-Abdominal Extension After Abdominoplasty: A Rare Presentation.

作者信息

Muneer Mohammed, Badran Saif, Zahid Rehan, Abdelmageed Amal, AlDulaimi Mohamed Murshid

机构信息

Department of Plastic Surgery, Hamad Medical Corporation, Doha, Qatar.

Department of Surgery, Weill Cornel Medical College, Doha, Qatar.

出版信息

Am J Case Rep. 2019 Jul 4;20:953-956. doi: 10.12659/AJCR.916227.

Abstract

BACKGROUND Desmoid tumors are fibrous neoplasms that originate from the musculoaponeurotic structures in the body. Abdominal wall desmoid tumors are rare, but they can be locally aggressive, with high incidence of recurrence. These tumors are more common in young, fertile women. They frequently occur during or after pregnancy. CASE REPORT We present the case of a 63-year-old post-menopausal woman with a desmoid tumor of the anterior abdominal wall. She had no relevant family history. During abdominoplasty, an incidental mass was excised and biopsied, and was identified as a desmoid tumor with free margins. One year later, the patient presented with vague abdominal discomfort and feeling of heaviness. An incision was made through the previous abdominoplasty scar to maintain the aesthetic outcome. A large mass, arising from the abdominal wall and extending intra-abdominally, was excised and was determined to be a recurrent desmoid tumor. CONCLUSIONS Recurrent anterior abdominal wall desmoid tumors in post-menopausal women are rare and locally aggressive, with a high risk of recurrence. During abdominal wall repair in abdominoplasty, desmoid tumor filaments might seed deep intra-abdominally. Therefore, it is necessary to take adequate safe margins before abdominal wall repair. Post-operatively, surgeons should keep a high index of suspicion for tumor recurrence.

摘要

背景

硬纤维瘤是起源于身体肌纤维结构的纤维性肿瘤。腹壁硬纤维瘤罕见,但具有局部侵袭性,复发率高。这些肿瘤在年轻的育龄女性中更为常见,常在孕期或产后发病。病例报告:我们报道一例63岁绝经后女性腹壁硬纤维瘤病例。她无相关家族史。在腹壁成形术过程中,偶然发现一个肿物并切除送检,病理结果为切缘阴性的硬纤维瘤。一年后,患者出现腹部隐痛及坠胀感。通过原腹壁成形术切口进行手术,以保持美观效果。切除一个源于腹壁并向腹腔内延伸的大肿物,病理结果为复发性硬纤维瘤。结论:绝经后女性复发性腹壁硬纤维瘤罕见且具有局部侵袭性,复发风险高。在腹壁成形术进行腹壁修复时,硬纤维瘤细丝可能播散至腹腔深部。因此,腹壁修复前需切除足够的安全切缘。术后,外科医生应高度怀疑肿瘤复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5cb/6621933/ef6d946a1818/amjcaserep-20-953-g001.jpg

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