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手腕部浅表性血管黏液瘤:病例报告及文献复习。

Superficial Angiomyxoma of the Wrist: Case Report and Literature Review.

机构信息

Section of Orthopaedic Surgery, Department of Medicine, Fukuoka Dental College, Fukuoka, Japan.

Section of Orthopaedic Surgery, Department of Medicine, Fukuoka Dental College, Fukuoka, Japan

出版信息

In Vivo. 2023 Jan-Feb;37(1):503-505. doi: 10.21873/invivo.13107.

Abstract

BACKGROUND/AIM: Superficial angiomyxoma (SAM) is a rare benign soft-tissue tumor that usually occurs in the trunk, head and neck, and lower extremity of middle-aged adults. Herein, we describe an unusual case of SAM of the wrist, which was initially diagnosed as a ganglion cyst on imaging.

CASE REPORT

The patient was a 71-year-old man with no history of trauma who presented with a 2-year history of a palpable mass in the left wrist. Physical examination revealed a 2.5-cm, elastic hard, mobile, nontender mass. Magnetic resonance imaging revealed a well-defined mass with iso-signal intensity relative to skeletal muscle on T1-weighted sequences and very high signal intensity on T2-weighted fat-suppressed sequences. Subtle internal enhancement was seen following gadolinium administration. Complete excision was performed under general anesthesia with tourniquet control. Histologically, the lesion was composed of bland spindle to stellate-shaped cells in an abundant myxoid stroma. Immunohistochemically, the lesional cells were positive for CD34 but negative for S-100 protein, smooth-muscle actin, desmin, epithelial membrane antigen and pancytokeratin. These findings were consistent with a diagnosis of SAM. There was no clinical evidence of recurrence during a follow-up period of 3 months.

CONCLUSION

Although extremely rare, SAM should be considered in the differential diagnosis of a cyst-like solid lesion near small joints.

摘要

背景/目的:浅表性血管黏液瘤(SAM)是一种罕见的良性软组织肿瘤,通常发生于中老年人的躯干、头颈部和下肢。本文描述了腕部不常见的 SAM 病例,该病例最初在影像学上被诊断为腱鞘囊肿。

病例报告

患者为 71 岁男性,无外伤史,左腕部有 2 年可触及肿块的病史。体格检查发现一个 2.5cm 大小、有弹性、坚硬、可移动、无触痛的肿块。磁共振成像显示边界清楚的肿块,在 T1 加权序列上与骨骼肌等信号强度,在 T2 加权脂肪抑制序列上信号强度非常高。钆造影后可见轻微的内部强化。在止血带控制下全身麻醉下进行完全切除。组织学上,病变由丰富黏液样基质中的温和梭形至星状细胞组成。免疫组化染色显示病变细胞 CD34 阳性,S-100 蛋白、平滑肌肌动蛋白、结蛋白、上皮膜抗原和广谱细胞角蛋白阴性。这些发现与 SAM 的诊断一致。在 3 个月的随访期间,无临床复发证据。

结论

尽管极其罕见,但在临近小关节的囊性实性病变的鉴别诊断中应考虑 SAM。

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