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黏液纤维肉瘤:在印度四肢的罕见病例及其综合治疗

Myxofibrosarcoma: An Unusual Occurrence in the Extremities and Its Integrated Management in India.

作者信息

Tanweer A M Abidah, V Shruthi Kamal, Venkata Mahipathy Surya Rao Rao, Gunasekaran Marun Raj, N K Ragavendra

机构信息

Department of General Surgery, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.

Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.

出版信息

Cureus. 2024 Sep 12;16(9):e69272. doi: 10.7759/cureus.69272. eCollection 2024 Sep.

DOI:10.7759/cureus.69272
PMID:39398800
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11470838/
Abstract

Sarcomas tend to spread to distant regions, recur locally, and exhibit various histological characteristics. They can also present differently in different areas of the body. Myxofibrosarcoma (MFS) is a typical soft-tissue sarcoma in elderly individuals, distinguished by the presence of both myxoid and fibrous tissue components. This classification might be based on its aggression, with low, middle, and high grades. We address a woman in her 50s who had spindle cell sarcoma measuring 25 x 20 cm on the anterior portion of her right thigh, along with an ulcer and discharge on top of it. The patient was evaluated with a computed tomography lower limb angiogram to look for the vasculature of the swelling. After a wide surgical excision of the mass followed by right anterolateral flap reconstruction, the patient was transferred to medical oncology for further management. The histopathological analysis revealed a grade 2 MFS. The patient has a substantial risk of morbidity and mortality due to the huge size of the sarcoma. This case report discusses the diagnosis and management of MFS, which requires integrated management involving the general surgery, vascular, and plastic surgery teams.

摘要

肉瘤易于扩散至远处、局部复发,并呈现出各种组织学特征。它们在身体的不同部位也可能表现各异。黏液纤维肉瘤(MFS)是老年人群中一种典型的软组织肉瘤,其特征是同时存在黏液样和纤维组织成分。这种分类可能基于其侵袭性,分为低、中、高分级。我们报告一名50多岁的女性,其右大腿前部有一个大小为25×20厘米的梭形细胞肉瘤,上面伴有溃疡和渗液。对该患者进行了下肢计算机断层血管造影检查,以查找肿块的血管分布情况。在对肿块进行广泛手术切除并随后进行右前外侧皮瓣重建后,患者被转至医学肿瘤学进行进一步治疗。组织病理学分析显示为2级MFS。由于肉瘤体积巨大,该患者有较高的发病和死亡风险。本病例报告讨论了MFS的诊断和治疗,这需要普通外科、血管外科和整形外科团队的综合管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/7a1e359da301/cureus-0016-00000069272-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/27b2361a7760/cureus-0016-00000069272-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/c3c8cb504278/cureus-0016-00000069272-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/7cdf1505c8d7/cureus-0016-00000069272-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/3d4415784cf9/cureus-0016-00000069272-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/7a1e359da301/cureus-0016-00000069272-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/27b2361a7760/cureus-0016-00000069272-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/c3c8cb504278/cureus-0016-00000069272-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/7cdf1505c8d7/cureus-0016-00000069272-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/3d4415784cf9/cureus-0016-00000069272-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e05d/11470838/7a1e359da301/cureus-0016-00000069272-i05.jpg

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本文引用的文献

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Sci Rep. 2024 May 28;14(1):12232. doi: 10.1038/s41598-024-63035-6.
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Modeling Myxofibrosarcoma: Where Do We Stand and What Is Missing?黏液纤维肉瘤建模:我们目前的状况如何以及还缺少什么?
Cancers (Basel). 2023 Oct 25;15(21):5132. doi: 10.3390/cancers15215132.
3
Biology and Management of High-Grade Myxofibrosarcoma: State of the Art and Future Perspectives.
高级别黏液纤维肉瘤的生物学特性与管理:现状与未来展望
Diagnostics (Basel). 2023 Sep 22;13(19):3022. doi: 10.3390/diagnostics13193022.
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Superficial low-grade fibromyxoid sarcoma.浅表性低度纤维黏液样肉瘤。
J Cutan Pathol. 2023 Feb;50(2):147-154. doi: 10.1111/cup.14325. Epub 2022 Nov 2.
5
Myxofibrosarcoma landscape: diagnostic pitfalls, clinical management and future perspectives.黏液纤维肉瘤概况:诊断陷阱、临床管理及未来展望
Ther Adv Med Oncol. 2022 Jun 28;14:17588359221093973. doi: 10.1177/17588359221093973. eCollection 2022.
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Spindle cell sarcoma: a case report of diagnostic and therapeutic quandary in a low resource setting.梭形细胞肉瘤:资源匮乏地区诊断与治疗困境的病例报告
J Surg Case Rep. 2022 Jan 21;2022(1):rjab612. doi: 10.1093/jscr/rjab612. eCollection 2022 Jan.
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Overview of malignant soft-tissue sarcomas of the limbs.四肢恶性软组织肉瘤概述。
Clin Radiol. 2021 Dec;76(12):940.e1-940.e16. doi: 10.1016/j.crad.2021.08.011. Epub 2021 Oct 1.
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High-Grade Malignant Spindle Cell Sarcoma of the Pelvis Presenting With Bloody Diarrhea and Urinary Retention: A Rare Case With a Rare Presentation.以血性腹泻和尿潴留为表现的骨盆高级别恶性梭形细胞肉瘤:一例罕见表现的罕见病例
Cureus. 2020 Sep 23;12(9):e10622. doi: 10.7759/cureus.10622.
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