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[侵袭性纤维瘤病的一例外科病例]

[A surgical case of aggressive fibromatosis].

作者信息

Yoshida S, Kimura H, Iwai N, Yasufuku K, Yamaguchi Y, Takahara Y

机构信息

Department of Surgery, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1997 Dec;45(12):2016-20.

PMID:9455118
Abstract

A case of "aggressive fibromatosis" which appeared in posterior mediastinum is reported. A 50-year-old woman was admitted to our hospital with right shoulder pain. The tumor surrounded the right vertebral artery and infiltrated into the right sympathetic nerve, brachial plexus and muscle tissue. It was suspected of neurogenic tumor by percutaneous needle biopsy. Removal of the tumor and partial resection of the invaded vertebral artery and brachial plexus were made in Aug. 10, 1996. In postoperative examination, the tumor was 6.2 x 6.5 x 4.5 cm in size and diagnosed pathologically as "aggressive fibromatosis". Postoperative course was uneventful, but Horner's symptoms and motor disturbances of IV, V, fingers of the right hand were slightly occurred. Radiotherapy of 60 Gy was done after operation. There is no recurrence to date 17 months after surgery. As for the character of this disease, it seldom metastasizes, but grows infiltratively and the recurrence after operation is an important problem. In particular, the neck and the head are important because surgical margin is not provided enough, anatomically. Therefore, chemotherapy or radiotherapy after operation is needed. In this case, radiotherapy was done after operation. So, there is not the recurrence and passes to date 17 months after surgery. But, follow-up of long terms is necessary because it may recur after postoperative therapies.

摘要

报告1例发生于后纵隔的“侵袭性纤维瘤病”。一名50岁女性因右肩疼痛入院。肿瘤包绕右侧椎动脉并浸润至右侧交感神经、臂丛神经及肌肉组织。经皮针吸活检怀疑为神经源性肿瘤。1996年8月10日行肿瘤切除及受累椎动脉和臂丛神经部分切除术。术后检查,肿瘤大小为6.2×6.5×4.5 cm,病理诊断为“侵袭性纤维瘤病”。术后病程顺利,但出现轻度霍纳综合征及右手第Ⅳ、Ⅴ指运动障碍。术后行60 Gy放疗。术后17个月至今无复发。关于本病的特点,很少发生转移,但呈浸润性生长,术后复发是一个重要问题。特别是头颈部,由于解剖学上手术切缘不足,尤为重要。因此,术后需要化疗或放疗。本例术后行放疗。所以,术后17个月至今无复发。但是,由于术后治疗后仍可能复发,需要长期随访。

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