Antar Ryan M, Kidwai M Sulaiman, Brammer Iris, Zhang Athena, Mantilla-Rivas Esperanza, Hussain Ahmad, Oh Albert K, Rogers Gary F
From the Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC.
Plast Reconstr Surg Glob Open. 2024 Dec 3;12(12):e6358. doi: 10.1097/GOX.0000000000006358. eCollection 2024 Dec.
Calcifying aponeurotic fibroma is a rare tumor that can involve the upper extremity, but deep hand space involvement is exceptionally uncommon and presents unique diagnostic and treatment challenges. We present a 9-year-old girl with a progressively enlarging mass on the ulnar side of the left palm. Magnetic resonance imaging revealed an ill-defined tumor with fatty infiltration spanning the third and fourth metacarpal spaces, suspicious of an aggressive tumor. The delay in diagnosis, likely stemming from the location in the deep space of the palm and lack of functional impairment, allowed this lesion to become atypically large and expansive. Given the child's age, a marginal excision was performed with careful preservation of the adjacent tendons, bone, and neurovascular structures. Although long-term monitoring for recurrence is ongoing, the patient had no evidence of recurrence at 1-year follow-up.
钙化性腱膜纤维瘤是一种罕见的肿瘤，可累及上肢，但累及手部深部间隙极为罕见，且在诊断和治疗上面临独特挑战。我们报告一名9岁女孩，其左手掌尺侧有一逐渐增大的肿块。磁共振成像显示一个边界不清的肿瘤，伴有脂肪浸润，跨越第三和第四掌骨间隙，怀疑是侵袭性肿瘤。诊断延迟可能是由于肿瘤位于手掌深部间隙且无功能障碍，导致该病变异常增大并呈浸润性生长。鉴于患儿年龄，进行了边缘性切除，小心保留了相邻的肌腱、骨骼和神经血管结构。尽管正在进行长期复发监测，但患者在1年随访时无复发迹象。
