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足部复发性硬纤维瘤的罕见定位:一例报告并文献复习

Rare localisation of a recurrent desmoid tumour of the foot: A case report and review of the literature.

作者信息

El Qadiri Yassine, El Adaoui Oussama, El Andaloussi Yasser, Haddoun Ahmed Reda, Bennouna Driss, Fadili Mustapha

机构信息

Orthopaedic Trauma Department wing 4, University Hospital Center Ibn Rochd, Casablanca 20100, Morocco.

Orthopaedic Trauma Department wing 4, University Hospital Center Ibn Rochd, Casablanca 20100, Morocco.

出版信息

Int J Surg Case Rep. 2024 May;118:109370. doi: 10.1016/j.ijscr.2024.109370. Epub 2024 Feb 12.

Abstract

INTRODUCTION AND IMPORTANCE

Aggressive fibromatosis or desmoid tumour is a rare soft tissue tumour that develops from supporting tissues and fascia. Although benign, fibromatosis is a tumour that can be locally invasive, and surgical treatment is often difficult. The interest of this observation is to show the particular characteristics of desmoid tumours: the frequency, the major difficulties of excision and the role of adjuvant treatment in the management of these tumours.

CASE PRESENTATION

The patient was 27 years old male, and had a pathological history of a recurrent desmoid tumour on the dorsal surface of the right foot, which had been present for 10 years, had been operated on 5 times and could not be completely removed. A radiological work-up confirmed the nature of the lesion, necessitating a biopsy, which confirmed the diagnosis of a recurrence of the desmoid tumour on the sole of the foot.

CLINICAL DISCUSSION

Desmoid tumour is a rare tumour with less than 5 cases per million inhabitants, histologically benign and belonging to the deep fibromatosis group. The average age is 30, with a predominance of women. The most common location for desmoid tumours is the abdominal wall, and they are usually single and unilateral. The treatment of desmoid tumours is primarily surgical, but is fraught with technical difficulties due to the absence of any cleavage plane and the particularly tight adhesions to neighbouring structures. Radiotherapy or hormone therapy has been advocated as an adjunct to tumour resection, but its value is debated, and recurrence occurs in 50-80 % of cases.

CONCLUSION

The desmoid tumour is a very rare tumour, with an infiltrating and aggressive benign character, whose surgical treatment is difficult, and whose evolution is marked by recurrences.

摘要

引言与重要性

侵袭性纤维瘤病或韧带样瘤是一种罕见的软组织肿瘤,起源于支持组织和筋膜。尽管纤维瘤病是良性肿瘤,但具有局部侵袭性,手术治疗往往困难。本病例报告旨在展示韧带样瘤的特殊特征:发病率、切除的主要困难以及辅助治疗在这些肿瘤管理中的作用。

病例介绍

患者为27岁男性,有右脚背复发性韧带样瘤的病史,该肿瘤已存在10年,接受过5次手术,但仍无法完全切除。影像学检查确定了病变性质,需进行活检,活检证实为足底韧带样瘤复发。

临床讨论

韧带样瘤是一种罕见肿瘤,每百万居民中发病少于5例,组织学上为良性,属于深部纤维瘤病组。平均发病年龄为30岁,女性居多。韧带样瘤最常见的部位是腹壁,通常为单发且单侧。韧带样瘤的治疗主要是手术,但由于缺乏明确的解剖层面以及与周围结构粘连紧密,手术技术难度大。放疗或激素治疗被提倡作为肿瘤切除的辅助手段,但其价值存在争议,50%-80%的病例会复发。

结论

韧带样瘤是一种非常罕见的肿瘤,具有浸润性和侵袭性的良性特征,手术治疗困难,且病程以复发为特点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b57a/11002292/ec123afa2e8f/gr1.jpg

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