Imai Naoya, Ohe Naoyuki, Ozeki Michio, Endo Saori, Yasue Shiho, Iwama Toru
Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan.
Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Gifu, Japan.
NMC Case Rep J. 2021 Apr 2;8(1):63-67. doi: 10.2176/nmccrj.cr.2020-0006. eCollection 2021 Apr.
Desmoid-type fibromatosis (DTF) is a rare locally aggressive soft tissue neoplasm without metastatic potential. Here, we report a very rare sporadic case of an intracranial supratentorial extradural DTF measuring 82 mm in a 1-year-old girl, that recurred twice following surgery over the course of 16 months, requiring two other surgeries. In three surgeries, we resected a huge tumor with the dura which was thought to be tumor origin and removed this tumor infiltrated the frontal skull base by drilling widely. Furthermore, we treated the tumor invading the bone flap using liquid nitrogen for 20 minutes, and subsequently used it to perform a cranioplasty. This tumor has not recurred for past 8 months. DTF invading the skull base is prone to recurrence, and liquid nitrogen treatment is considered to be effective in pediatric patients, who need cranioplasty with tumor-infiltrating autologous bone flaps.
韧带样型纤维瘤病(DTF)是一种罕见的局部侵袭性软组织肿瘤,无转移潜能。在此,我们报告一例极为罕见的散发型病例,一名1岁女童颅内幕上硬膜外DTF,大小为82毫米,在16个月的病程中术后复发两次,需要另外进行两次手术。在三次手术中,我们切除了与硬脑膜相连的巨大肿瘤,硬脑膜被认为是肿瘤起源部位,并通过广泛钻孔切除了浸润额颅底的肿瘤。此外,我们使用液氮对侵犯骨瓣的肿瘤进行了20分钟的治疗,随后用其进行颅骨成形术。该肿瘤在过去8个月未复发。侵袭颅底的DTF易于复发,液氮治疗被认为对需要用肿瘤浸润的自体骨瓣进行颅骨成形术的儿科患者有效。