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髂骨促结缔组织增生性纤维瘤:一例随访4个月的病例报告及文献复习

Desmoplastic fibroma of the ilium: A case report with 4-month follow-up and literature review.

作者信息

Gao Lei, Li Can, Zheng Wensong, Yu Hong

机构信息

Department of Medical Imaging, Hebei Medical University Third Hospital, Shijiazhuang, Hebei Province, China.

CT and MRI Center, Juancheng People's Hospital, Heze, Shandong Province, China.

出版信息

Medicine (Baltimore). 2025 Jul 18;104(29):e43503. doi: 10.1097/MD.0000000000043503.

DOI:10.1097/MD.0000000000043503
PMID:40696596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12282707/
Abstract

RATIONALE

Desmoplastic fibroma of the bone (DFB) is a rare and locally aggressive tumor that originates from the bone. We present a case of DFB involving the ilium that progressed over a 4-month follow-up period. To our knowledge, this is the first report detailing the short-term follow-up of DFB.

PATIENT CONCERNS

A 28-year-old male patient was admitted to our institution because of unexplained right iliac pain. Radiological assessment revealed osteolytic and expansive bone destruction in the right ilium along with linear hypointensity on T2-weighted imaging. After the 4-month follow-up, computed tomography images demonstrated an increase in lesion size.

DIAGNOSES

The initial diagnosis was a fibrous tumor. Histopathological examination after the operation confirmed a diagnosis of DFB.

INTERVENTIONS AND OUTCOMES

The patient underwent extensive resection, reconstruction with bone cement, and internal fixation. No radiological evidence of tumor recurrence was observed 5 years after surgery.

LESSONS

This study provides the initial documentation of the short-term imaging progression characteristics of DFB in the iliac bone. Within the framework of the World Health Organization classification of bone tumors, DFB is categorized as an intermediate tumor based on its biological behavior. The case presented herein illustrates rapid progression of the tumor over a short period. Such findings underscore the paramount importance of achieving an accurate diagnostic evaluation through comprehensive imaging and the necessity of timely surgical intervention to effectively manage tumors and mitigate potential adverse outcomes.

摘要

原理

骨促结缔组织增生性纤维瘤(DFB)是一种罕见的、具有局部侵袭性的骨源性肿瘤。我们报告一例累及髂骨的DFB病例,该病例在4个月的随访期内病情进展。据我们所知,这是第一份详细描述DFB短期随访情况的报告。

患者情况

一名28岁男性患者因不明原因的右髂骨疼痛入住我院。影像学评估显示右髂骨有溶骨性和膨胀性骨质破坏,T2加权成像上有线性低信号。4个月的随访后,计算机断层扫描图像显示病变大小增加。

诊断

最初诊断为纤维瘤。术后组织病理学检查确诊为DFB。

干预措施及结果

患者接受了广泛切除、骨水泥重建和内固定。术后5年未观察到肿瘤复发的影像学证据。

经验教训

本研究提供了髂骨DFB短期影像学进展特征的初步记录。在世界卫生组织骨肿瘤分类框架内,DFB根据其生物学行为被归类为中间型肿瘤。本文所述病例说明了肿瘤在短时间内的快速进展。这些发现强调了通过全面成像实现准确诊断评估的至关重要性,以及及时进行手术干预以有效管理肿瘤并减轻潜在不良后果的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24f/12282707/ea3c71d402b5/medi-104-e43503-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24f/12282707/232f1352a590/medi-104-e43503-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24f/12282707/ea3c71d402b5/medi-104-e43503-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24f/12282707/232f1352a590/medi-104-e43503-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24f/12282707/ea3c71d402b5/medi-104-e43503-g002.jpg

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本文引用的文献

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Desmoplastic fibroma in a child: a 9-year follow-up case report.儿童促纤维增生性纤维瘤:9 年随访病例报告。
BMC Musculoskelet Disord. 2024 Apr 20;25(1):306. doi: 10.1186/s12891-024-07454-6.
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Clinical and Imaging Features of Desmoplastic Fibroma of Bone for Correct Diagnosis and Differentiation.骨促结缔组织增生性纤维瘤的临床与影像学特征以助正确诊断及鉴别
Curr Med Imaging. 2022;18(10):1093-1098. doi: 10.2174/1573405618666220411125408.
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Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up.
非手术成功治疗髂骨巨大促纤维组织增生性纤维瘤:一例长期随访病例报告
Case Rep Orthop. 2020 Mar 20;2020:5380598. doi: 10.1155/2020/5380598. eCollection 2020.
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Desmoplastic fibroma of the mandible: a rare gnathic bone tumor with a review of the literature.下颌骨促结缔组织增生性纤维瘤:一种罕见的颌骨肿瘤并文献复习
Autops Case Rep. 2019 Sep 27;9(4):e2019091. doi: 10.4322/acr.2019.091. eCollection 2019 Oct-Dec.
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Desmoplastic fibroma of bone arising in the cortex of the proximal femur.发生于股骨近端皮质的骨促结缔组织增生性纤维瘤。
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Massive rare desmoplastic fibroma of the ilium and ischium in a young adult: A case report.一名年轻成人髂骨和坐骨的巨大罕见促结缔组织增生性纤维瘤:病例报告。
Medicine (Baltimore). 2017 Dec;96(48):e8962. doi: 10.1097/MD.0000000000008962.
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Diagnosis and Differential Diagnosis of Desmoplastic Fibroblastoma by Clinical, Radiological, and Histopathological Analyses.临床、影像学和组织病理学分析诊断硬纤维瘤及其鉴别诊断。
Chin Med J (Engl). 2018 Jan 5;131(1):32-36. doi: 10.4103/0366-6999.221274.
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Desmoplastic fibroma of bone: A rare bone tumour.骨促结缔组织增生性纤维瘤:一种罕见的骨肿瘤。
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