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肩部孤立性恶性蝾螈肿瘤:一例报告。

Sporadic Malignant Triton Tumor of Shoulder: a Case Report.

机构信息

Orthopedic Department at Royal Rehabilitation Center at King Hussein Medical Center, Amman, Jordan.

Radiology Department at King Hussein Medical Center, Amman, Jordan.

出版信息

Med Arch. 2024;78(2):174-176. doi: 10.5455/medarh.2024.78.174-176.

Abstract

BACKGROUND

Malignant triton tumors (MTT) are subtype of malignant peripheral nerve sheath tumor (MPNST) which develop from Schwan cells of peripheral nerves or within neurofibromas, and shows rhabdomyoblastic differentiation. It is a rare soft tissue tumor with poor prognosis.

OBJECTIVE

We report a case of Malignant Triton Tumor (MTT) arising in the right shoulder in a 46 year old male patient presented to our Musculoskeletal Oncology Clinic at Royal Rehabilitation center at King Hussein Medical Center during June 2018.

CASE PRESENTATION

The patient was complaining of an 8 months long progressive right shoulder pain and swelling at the posterior lateral area of the shoulder. As accurate diagnosis is crucial in such case, investigations that included x-rays and magnetic resonance imaging (MRI) demonstrated an soft tissue tumor involving the right shoulder area leading to the differential diagnosis of aggressive soft tissue tumor which laid down the plan of an open incisional biopsy to be reported histopathological as a case of Malignant Triton Tumor which is a very rare and aggressive sarcoma originates from the peripheral nerve sheaths as it is subtype of malignant peripheral nerve sheath tumors after which excision of the entire tumor with safety margin was performed and referred for adjuvant chemotherapy.

CONCLUSION

The treatment of choice is radical tumor excision with wide margins followed by chemotherapy and /or radiotherapy to improve the 5 years survival rates.

摘要

背景

恶性蝾螈瘤(MTT)是一种恶性外周神经鞘瘤(MPNST)的亚型,它起源于周围神经的施万细胞或神经纤维瘤内,并表现出横纹肌样分化。它是一种预后较差的罕见软组织肿瘤。

目的

我们报告了 1 例 46 岁男性患者右侧肩部恶性蝾螈瘤(MTT)的病例,该患者于 2018 年 6 月在侯赛因国王医学中心皇家康复中心的肌肉骨骼肿瘤专科诊所就诊。

病例介绍

患者诉 8 个月来右肩部进行性疼痛和肿胀,位于肩部后侧外侧。由于此类病例的准确诊断至关重要,包括 X 光和磁共振成像(MRI)在内的检查显示右肩部有软组织肿瘤,导致鉴别诊断为侵袭性软组织肿瘤,这为开放性切开活检制定了计划,组织病理学报告为恶性蝾螈瘤,这是一种非常罕见的侵袭性肉瘤,起源于外周神经鞘,是恶性外周神经鞘瘤的亚型,随后进行了整个肿瘤的安全边缘切除,并进行辅助化疗。

结论

首选治疗方法是根治性肿瘤切除术,辅以化疗和/或放疗,以提高 5 年生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7316/10983085/d4c0c9c37b64/medarch-78-174-g001.jpg

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