Yuan Zhen, Wang Jinhui, Wang Yongxue, Feng Fengzhi, Pan Lingya, Xiang Yang, Shi Xiaohua
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
Front Surg. 2022 May 27;9:899329. doi: 10.3389/fsurg.2022.899329. eCollection 2022.
The study aimed to explore the clinical characteristics, treatment, and prognosis of cellular angiofibroma in females.
We performed a retrospective study in patients with vulvovaginal cellular angiofibroma treated at Peking Union Medical College Hospital between August 2012 and October 2021.
Eight patients were included in our study, with 7 cases of vulvar tumors and 1 case of vaginal stump tumors. The median age at diagnosis was 47.5 years (range, 38-83 years). The tumors were found incidentally in two patients (2/8, 25.00%) without specific history before diagnosis surgery. Of the other six patients, the median history from onset of the mass to diagnosis was 5.5 years (range, 3-14 years). Complete excision was performed in all 8 patients. According to histopathologic examination, the median tumor size was 3.4 cm (range, 1.7-11 cm). As the tumor size increased, both the operation time and postoperative length of stay increased. Gonadotrophin releasing hormone agonist was used in one case to minimize the size of the tumor, obtaining satisfactory results. Up to the last follow-up, no evidence of relapse was found in all 8 patients.
For vulvovaginal cellular angiofibroma, the mainstay of treatment remains surgical resection without residual tumor if possible; inadvertent urinary system injury and rectum injury should be avoided to the utmost; and enough attention should be paid to hemostasis to avoid hematoma after surgery. Before surgery, hormone receptor modulators may be considered to minimize the size of the tumor to reduce the surgery-associated risk.
本研究旨在探讨女性细胞性血管纤维瘤的临床特征、治疗方法及预后。
我们对2012年8月至2021年10月在北京协和医院接受治疗的外阴阴道细胞性血管纤维瘤患者进行了一项回顾性研究。
我们的研究纳入了8例患者,其中7例为外阴肿瘤,1例为阴道残端肿瘤。诊断时的中位年龄为47.5岁(范围38 - 83岁)。2例患者(2/8,25.00%)在诊断性手术前无特殊病史,肿瘤为偶然发现。其他6例患者中,从肿物出现到诊断的中位病程为5.5年(范围3 - 14年)。所有8例患者均行完整切除。根据组织病理学检查,肿瘤中位大小为3.4 cm(范围1.7 - 11 cm)。随着肿瘤大小增加,手术时间和术后住院时间均延长。1例患者使用促性腺激素释放激素激动剂使肿瘤体积缩小,取得了满意效果。截至最后一次随访,所有8例患者均无复发迹象。
对于外阴阴道细胞性血管纤维瘤,治疗的主要方法仍是手术切除,尽可能无肿瘤残留;应最大程度避免意外的泌尿系统损伤和直肠损伤;应充分重视止血以避免术后血肿。手术前可考虑使用激素受体调节剂缩小肿瘤体积以降低手术相关风险。