PDF(Pubmed)
Abstract：
A desmoid tumor (DT) is a rare benign neoplasm arising from muscle aponeurosis, associated mostly with trauma or pregnancy. DT has an infiltrative and locally aggressive growth pattern and usually does not metastasize. However, it has a high recurrence and complication rate. When it occurs in pregnancy, the pregnancy and delivery is taken as an individual case for optimal management by physicians and midwifes, who need to be cautious in finding the optimal delivery mode for the patient, which depends on the tumor size, location, behavior, and past history. The authors report a case of 29-year-old pregnant woman who previously underwent systemic oncological treatment for a large abdominal wall desmoid tumor and became pregnant afterwards. The history of DT presented a follow-up and delivery challenge. Observational management was chosen with an elective cesarean section at week 38 + 4 of pregnancy with uncomplicated postpartum follow-up. The authors detail the clinical management and chosen therapeutic approach; chemotherapy can be a choice in the treatment options for patients with DTs, although the majority of DTs are treated surgically with subsequent mesh plastic. Moreover, the authors provide a systematic review of the literature focused on the treatment management of DTs in pregnant women during pregnancy and the postpartum period, as pregnancy-associated desmoid tumors are a specific condition, where the optimal management is not well established, despite some guidelines for non-pregnant patients.
摘要：
韧带样肿瘤（DT）是一种罕见的由肌肉腱膜引起的良性肿瘤，主要与外伤或怀孕有关。DT具有渗透性和局部侵略性的生长模式，通常不会转移。然而,复发率和并发症发生率高。当它发生在怀孕时，怀孕和分娩被视为医生和助产士最佳管理的个案，在为患者寻找最佳分娩模式时需要谨慎，这取决于肿瘤的大小，location,行为，和过去的历史。作者报告了一例29岁的孕妇，该孕妇先前曾接受过大型腹壁硬纤维瘤的全身肿瘤治疗，随后怀孕。DT的历史提出了后续行动和交付挑战。在妊娠第38+4周选择选择性剖宫产的观察性管理，产后随访无并发症。作者详细介绍了临床管理和选择的治疗方法；化疗可以成为DTs患者治疗选择的一种选择，尽管大多数DTs都是通过随后的网状塑料进行手术治疗的。此外，作者提供了一个系统的文献，重点是孕妇在怀孕期间和产后期间DTs的治疗管理，因为妊娠相关的硬纤维瘤是一种特定条件，在没有建立最佳管理的地方，尽管一些针对非怀孕患者的指南。
