Huang Zhilan, Li Jinghong, Xu Houyun, Liu Jiaying, Yang Tian, Zhang Caijuan, Jin Xuan, Hu Jibo, Yang Jun
Department of Radiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Department of Emergency Medicine, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Front Oncol. 2024 Oct 11;14:1458486. doi: 10.3389/fonc.2024.1458486. eCollection 2024.
Cervical aggressive fibromatosis is a rare intermediate tumor characterized by invasive growth. Aggressive fibromatosis (AF), also referred to as desmoid-type fibrosarcoma or grade I fibrosarcoma, is a clonal proliferative lesion of fibroblasts located in deep soft tissues. While many cases have been reported, there are relatively few involving aggressive fibromatosis in the anterior inferior margin muscle space of the neck trapezius muscle. We present a case of pathologically confirmed left cervical aggressive fibromatosis, admitted to the Fourth Affiliated Hospital of Zhejiang University. The initial ultrasound and magnetic resonance imaging (MRI) scan of the patient revealed a mass in the left cervical dorsal muscle space, which slowly increased after one year. An enhanced MRI scan initially diagnosed the mass as a left cervical schwannoma. The patient underwent neck soft tissue lesion resection surgery, with postoperative confirmation of cervical aggressive fibromatosis. Our case suggests that fibromatosis cannot be ruled out, and the low-signal cord-like non-enhanced areas, representing collagen fiber characteristics after enhanced scanning, are significant imaging features in diagnosing cervical fibromatosis. Based on the available literature, we have conducted preliminary research on the clinical presentation, imaging manifestations, diagnosis, and differential diagnosis of cervical aggressive fibromatosis to improve clinical understanding and ensure timely clinical treatment.
颈部侵袭性纤维瘤病是一种罕见的以侵袭性生长为特征的中间型肿瘤。侵袭性纤维瘤病（AF），也称为韧带样型纤维肉瘤或I级纤维肉瘤，是一种位于深部软组织的成纤维细胞克隆性增殖性病变。虽然已有许多病例报道，但累及颈部斜方肌前下缘肌肉间隙的侵袭性纤维瘤病相对较少。我们报告一例经病理证实的左侧颈部侵袭性纤维瘤病病例，该患者入住浙江大学医学院附属第四医院。患者最初的超声和磁共振成像（MRI）扫描显示左侧颈部背侧肌肉间隙有一肿块，一年后缓慢增大。增强MRI扫描最初将该肿块诊断为左侧颈部神经鞘瘤。患者接受了颈部软组织病变切除术，术后确诊为颈部侵袭性纤维瘤病。我们的病例提示，不能排除纤维瘤病，增强扫描后代表胶原纤维特征的低信号条索状无强化区是诊断颈部纤维瘤病的重要影像学特征。基于现有文献，我们对颈部侵袭性纤维瘤病的临床表现、影像学表现、诊断及鉴别诊断进行了初步研究，以提高临床认识并确保及时的临床治疗。
