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在一家整脊诊所中,散发型硬纤维瘤酷似肌筋膜疼痛综合征。

Sporadic Desmoid Tumor Mimicking Myofascial Pain Syndrome in a Chiropractic Clinic.

作者信息

Chu Eric Chun-Pu, Sabourdy Edouard

机构信息

Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN.

Chiropractic Clinic, Franco-Vietnamese (FV) Hospital, Ho Chi Minh City, VNM.

出版信息

Cureus. 2023 Sep 4;15(9):e44653. doi: 10.7759/cureus.44653. eCollection 2023 Sep.

DOI:10.7759/cureus.44653
PMID:37799261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10548493/
Abstract

Chiropractors are primary healthcare providers who diagnose and manage various health conditions, including rare cases like desmoid tumors. Desmoid tumors are locally aggressive soft-tissue tumors originating from fibroblasts. This report presents the case of a 30-year-old woman who initially sought chiropractic care for persistent neck pain that was later discovered to be a symptom of a sporadic desmoid tumor. The patient presented with severe right upper neck pain, which was diagnosed as myofascial pain syndrome and yielded no significant improvement after various treatments. Physical examination by a chiropractor revealed a soft-tissue mass in the right upper trapezius and rhomboid region. In addition, magnetic resonance imaging revealed an intramuscular lesion measuring 8 × 4 cm in the right rhomboids, and subsequent biopsy confirmed the diagnosis of a sporadic desmoid tumor. The patient underwent successful surgical excision of the tumor. Postoperatively, the chiropractor initiated a comprehensive 12-week rehabilitation program that significantly improved the patient's range of motion and muscular strength and alleviated pain. The remarkable aspect of this case was the location of the tumor in the right rhomboid muscle, a less common site for desmoid tumors. This case underscores the crucial role of chiropractors as primary healthcare providers in the early detection of oncological cases and management of post-surgical rehabilitation.

摘要

整脊师是主要的医疗保健提供者,他们诊断和管理各种健康状况,包括像硬纤维瘤这样的罕见病例。硬纤维瘤是起源于成纤维细胞的局部侵袭性软组织肿瘤。本报告介绍了一名30岁女性的病例,她最初因持续的颈部疼痛寻求整脊治疗,后来发现这是散发性硬纤维瘤的症状。患者表现为严重的右上颈部疼痛,最初被诊断为肌筋膜疼痛综合征,经过各种治疗后没有明显改善。整脊师的体格检查发现右上斜方肌和菱形肌区域有一个软组织肿块。此外,磁共振成像显示右菱形肌有一个8×4厘米的肌内病变,随后的活检证实了散发性硬纤维瘤的诊断。患者成功接受了肿瘤的手术切除。术后,整脊师启动了一个为期12周的综合康复计划,该计划显著改善了患者的活动范围和肌肉力量,并减轻了疼痛。该病例的显著之处在于肿瘤位于右菱形肌,这是硬纤维瘤较少见的部位。该病例强调了整脊师作为主要医疗保健提供者在肿瘤病例早期检测和术后康复管理中的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aab/10548493/7db6fb571314/cureus-0015-00000044653-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aab/10548493/988f93d760aa/cureus-0015-00000044653-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aab/10548493/7db6fb571314/cureus-0015-00000044653-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aab/10548493/988f93d760aa/cureus-0015-00000044653-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aab/10548493/7db6fb571314/cureus-0015-00000044653-i02.jpg

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本文引用的文献

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Understanding the Utilization, Challenges, and Attitudes Towards Laboratory Testing and Radiological Imaging Among Chiropractors in Hong Kong: A Cross-Sectional Survey.了解香港脊医对实验室检测和放射成像的使用情况、挑战及态度:一项横断面调查。
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Sacral Chordoma Presenting as Back Pain in the Chiropractic Clinic: A Case Report.
在整脊治疗中通过磁共振成像早期检测脊柱肿瘤的重要性。
Cureus. 2024 Jan 1;16(1):e51440. doi: 10.7759/cureus.51440. eCollection 2024 Jan.
骶骨脊索瘤在整脊诊所表现为背痛:一例报告
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Prevention-Focused Care: The Potential Role of Chiropractors in Hong Kong's Primary Healthcare Transformation.以预防为重点的护理:脊医在香港基层医疗转型中的潜在作用。
Cureus. 2023 Mar 31;15(3):e36950. doi: 10.7759/cureus.36950. eCollection 2023 Mar.
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