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一例罕见的鼻腔纤维肉瘤:病例报告

A rare nasal fibrosarcoma: A case report.

作者信息

Masadah Rina, Jufri Nani Iriani, Ahmad Desy Ekamadayani, Faruk Muhammad

机构信息

Department of Pathology Anatomy, Faculty of Medicine, Hasanuddin University - Hasanuddin University Hospital, Makassar, Indonesia; Siloam Hospital, Makassar, Indonesia.

Siloam Hospital, Makassar, Indonesia; Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

出版信息

Int J Surg Case Rep. 2024 Jan;114:109160. doi: 10.1016/j.ijscr.2023.109160. Epub 2023 Dec 15.

Abstract

INTRODUCTION

Fibrosarcoma is a malignant neoplasm, with nasal localization uncommon. Clinically, the main symptoms are epistaxis and nasal obstruction. Microscopically, it is characterized by a dense proliferation of fibroblasts with a herringbone pattern and spindle-shaped cells with hyperchromatic nuclei.

PRESENTATION OF CASE

We report a nasal fibrosarcoma of a 37-year-old woman with a recurrent history of epistaxis and nasal obstruction for several years. A biopsy was performed, and the histopathological findings reported a dense proliferation of fibroblasts with a herringbone pattern and spindle-shaped cells with hyperchromatic nuclei. The immunohistochemistry was positive for Ki67, P53, and vimentin staining. The final diagnosis was nasal fibrosarcoma. The patient underwent functional endoscopic sinus surgery and extirpation of the tumor on the wall of the right maxilla, right ethmoid sinus, and right frontal area. Thirteen months later, the patient experienced a recurrence. An external approach was taken under general anesthesia via lateral rhinotomy with medial maxillectomy. The patient underwent chemotherapy with a regimen of paclitaxel and cisplatin for six cycles.

DISCUSSION

We gave chemotherapy in this case because the patient experienced a recurrence, tumor-free margins were not obtained, and a computed tomography scan showed bone involvement.

CONCLUSION

Nasal fibrosarcoma is a rare malignant neoplasm, which can be diagnosed by its histopathological features and immunohistochemistry.

摘要

引言

纤维肉瘤是一种恶性肿瘤,鼻腔定位并不常见。临床上,主要症状为鼻出血和鼻塞。显微镜下,其特征为成纤维细胞密集增生,呈人字形排列,细胞呈梭形,核染色质增多。

病例介绍

我们报告一例37岁女性鼻腔纤维肉瘤,有多年反复鼻出血和鼻塞病史。进行了活检,组织病理学检查结果显示成纤维细胞密集增生,呈人字形排列,细胞呈梭形,核染色质增多。免疫组化Ki67、P53和波形蛋白染色呈阳性。最终诊断为鼻腔纤维肉瘤。患者接受了功能性鼻内镜鼻窦手术,并切除了右上颌窦壁、右筛窦和右额区的肿瘤。13个月后,患者复发。在全身麻醉下通过外侧鼻切开术联合内侧上颌骨切除术采用外部入路。患者接受了六个周期的紫杉醇和顺铂化疗方案。

讨论

我们对该病例进行化疗是因为患者复发,未获得切缘阴性,且计算机断层扫描显示有骨质受累。

结论

鼻腔纤维肉瘤是一种罕见的恶性肿瘤,可通过其组织病理学特征和免疫组化进行诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5563/10770580/4c71e617bce7/gr1.jpg

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