Desmoid

Desmoid
  • 文章类型: Case Reports
    纤维瘤,也被称为侵袭性纤维瘤病,代表一种罕见的成纤维细胞增殖形式。这些肿瘤可能出现在整个身体的任何肌肉筋膜结构中。由于几个独特的特征,它们被归类为良性的:组织学上,它们表现出规则的有丝分裂活性,并且没有转移潜力。计算机断层扫描(CT)仍然是精确诊断的最终方式,强烈建议手术切除。此帐户详细介绍了位于31岁女性患者前腹壁的硬纤维状肿瘤的表现,该患者明显缺乏任何先前的手术干预措施。手术干预需要切除肿瘤并随后使用聚丙烯网片重建腹壁。术后,病人在三天后从医疗机构获释,没有经历术后并发症。随后是六个月的间隔,没有任何不良事件。
    Desmoid tumors, also referred to as aggressive fibromatosis, represent an uncommon form of fibroblastic proliferation. These neoplasms may arise within any musculoaponeurotic structure throughout the body. They are classified as benign due to several distinctive features: histologically, they exhibit regular mitotic activity and are devoid of metastatic potential. Computed tomography (CT) remains the definitive modality for precise diagnosis, and surgical excision is strongly advised. This account details the manifestation of a desmoid tumor located in the anterior abdominal wall of a 31-year-old female patient who notably lacks any prior surgical interventions. The surgical intervention entailed the excision of the neoplasm and subsequent reconstruction of the abdominal wall utilizing a polypropylene mesh. Postoperatively, the patient was released from the medical facility after a period of three days, having experienced no post-surgical complications. This was followed by a six-month interval free of any adverse events.
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  • 文章类型: Case Reports
    大多数纤维瘤样型纤维瘤病(DTF)病例表现出APC或CTNNB1突变。我们报告了一例肠系膜DTF,其中未发现APC或CTNNB1突变,但在RAD51C中发现了一个不确定意义的种系变异体(VUS)和在MYST3中发现了一个亚克隆突变.在这种情况下,这些遗传变化在DTF中是否重要,或遗传常规DTF细胞是否以低于检测的密度存在未知;在野生型APC/CTNNB1病例的进一步研究中看到结果将是令人感兴趣的。
    Most cases of desmoid-type fibromatosis (DTF) exhibit a mutation in APC or CTNNB1. We report a case of mesenteric DTF in which no mutation in APC or CTNNB1 was found, but a germline variant of uncertain significance (VUS) in RAD51C and a subclonal mutation in MYST3 were identified. Whether these genetic changes are important in DTF in this case, or whether genetically conventional DTF cells were present at a density below detection is unknown; it will be of interest to see results in further studies of wild-type APC/CTNNB1 cases.
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  • 文章类型: Journal Article
    背景:神经脂肪瘤病(LN)是一种罕见的疾病,其特征是周围神经大量增大,常伴有全身纤维脂肪增生和骨骼过度生长。
    方法:作者常规跟踪一名20岁男性出生后不久发现的腕部正中神经脂肪瘤病。他在另一个机构接受了病灶切除并伴有腓肠神经移植。临床上,虽然他的神经功能丧失一直稳定,他有持续的软组织生长。连续磁共振成像显示,修复部位近端持续存在LN,有证据表明腓肠移植物中脂肪增生,远端持续存在LN和脂肪增生。在近端和远端缝合线周围有一个渐进性的环形纤维化模式,其具有与纤维样型纤维瘤病(最近在神经肌肉性脉络膜瘤[NMC]纤维样型纤维瘤病中描述的模式)相似的放射学模式。
    结论:考虑到尽管基因级联不同,LN和NMC的神经反应相似,作者认为两个病变都会发生一个统一的过程。环状纤维增殖的模式与来自未指定营养因子的神经元介导的生长最一致,支持先前报道的神经衍生的“由内而外的机制”。“这一统一过程的临床后果被提出。
    BACKGROUND: Lipomatosis of nerve (LN) is a rare disorder characterized by the massive enlargement of peripheral nerves, frequently accompanied by generalized fibroadipose proliferation and skeletal overgrowth.
    METHODS: The authors have been routinely following a 20-year-old male for lipomatosis of median nerve at the wrist noted shortly after birth. He had undergone resection of the lesion accompanied by sural nerve grafting at another institution. Clinically, although his neurological loss of function has been stable, he has had continued soft tissue growth. Serial magnetic resonance imaging has revealed persistent LN proximal to the repair sites with evidence of fatty proliferation in the sural grafts and continued LN and fatty proliferation distally. There has been a progressive circumferential pattern of fibrosis around the proximal and distal suture lines, which has a similar radiological pattern to desmoid type fibromatosis (a pattern recently described in neuromuscular choristoma [NMC] desmoid-type fibromatosis).
    CONCLUSIONS: Considering the similar reaction of nerve in both LN and NMC despite differing genetic cascades, the authors believe a unifying process occurs in both lesions. The pattern of circumferential fibroproliferation would be most consistent with neuron-mediated growth from unspecified trophic factors, supporting a previously reported a nerve-derived \"inside-out mechanism.\" The clinical consequences of this unifying process are presented.
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  • 文章类型: Case Reports
    肠系膜纤维瘤病(DTF)是一种罕见的良性但侵袭性肿瘤,具有不可预测的生物学行为,从自发消退到广泛的局部浸润,并且具有很高的复发趋势。出现的症状通常是非特异性的,主要与肿瘤压迫邻近器官的大尺寸有关。影像学检查可以提示诊断,但确认是基于组织病理学和免疫组织化学检查。缺乏对这种肿瘤的病因和致病行为的了解导致治疗和预后挑战。未来的遗传研究可能有助于提高我们对这种肿瘤的理解,并制定适当的管理和后续计划。在这里,我们介绍了一名14岁的女性,她出现在急诊室,抱怨腹部弥漫性疼痛和腹胀。计算机断层扫描(CT)扫描显示,较大的肿块占据了大部分腹腔并压迫了邻近的器官。行剖腹探查术切除吻合,切除肿块的组织病理学和免疫组织化学检查与肠系膜DTF一致。
    Mesenteric desmoid-type fibromatosis (DTF) is a rare benign yet aggressive neoplasm that has an unpredictable biological behavior ranging from spontaneous regression to extensive local infiltration and has a high tendency for recurrence. The presenting symptoms are usually nonspecific and mostly related to the large size of the tumor compressing adjacent organs. Imaging studies can be suggestive of the diagnosis, but confirmation is based on histopathological and immunohistochemical examination. The lack of knowledge on the etiology and pathogenetic behavior of this tumor leads to therapeutic and prognostic challenges. Future genetic studies may help in advancing our understanding of this neoplasm and in formulating the proper management and follow-up plan. Here we present a case of a 14-year-old female who presented to the emergency room complaining of diffuse abdominal pain and distention. A computed tomography (CT) scan showed a large mass occupying most of the abdominal cavity and compressing adjacent organs. Exploratory laparotomy with resection and anastomosis was performed, and the histopathological and immunohistochemical examination of the resected mass was consistent with mesenteric DTF.
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  • 文章类型: Review
    纤维样型纤维瘤病(DF)是一种罕见的单克隆,以不可预测和可变的临床过程为特征的成纤维细胞增殖。我们介绍了一名56岁的女性,她在2012年因甲状腺乳头状癌而接受了甲状腺全切除术,并在随访期间在左宫颈外侧水平出现了宫颈肿块,提高肿瘤复发的诊断。颈部的计算机断层扫描显示出固体形成,颈部右侧区域的造影剂摄取不均。在胸罩的水平,观察到第二个26毫米的形成,内侧接触气管的左侧壁。进行外侧淋巴结清扫术,这是不完整的。组织学显示发现与纤维样型纤维瘤病一致。DF正在缓慢增殖,具有高侵袭能力的非转移性肿瘤,通常存在于家族性腺瘤性息肉病(FAP)-Gardner综合征中。我们的病例有大量结肠息肉病和结直肠癌一级亲属的病史。
    Desmoid-type fibromatosis (DF) is a rare monoclonal, fibroblastic proliferation characterized by an unpredictable and variable clinical course. We present the case of a 56-year-old woman who underwent total thyroidectomy for papillary thyroid carcinoma in 2012 and who developed a cervical mass at the left laterocervical level during follow-up, raising the diagnosis of tumor recurrence. Computed tomography of the neck showed solid formations with heterogeneous contrast uptake in the right lateral region of the neck. At the level of the thoracic operculum, a second 26-mm formation was observed that medially contacted the left lateral wall of the trachea. Lateral lymphadenectomy was performed, which was incomplete. Histology showed findings consistent with desmoid-type fibromatosis. DF are slowly proliferating, non-metastatic tumors with a highly invasive capacity that are usually present in familial adenomatous polyposis (FAP)-Gardner syndrome. Our case had a history of massive colonic polyposis and first-degree relatives of colorectal cancer.
    La fibromatosis de tipo desmoide (FD) es una rara proliferación fibroblástica monoclonal caracterizada por un curso clínico impredecible y variable. Presentamos el caso de una mujer de 56 años intervenida de tiroidectomía total por carcinoma papilar de tiroides en 2012 y que durante el seguimiento desarrolla una masa cervical a nivel laterocervical izquierdo, planteando el diagnóstico de recidiva tumoral. La tomografía computarizada de cuello demostró formaciones sólidas con captación heterogénea de contraste en la región lateral derecha del cuello. A nivel del opérculo torácico se observó una segunda formación de 26 mm que contactaba medialmente con la pared lateral izquierda de la tráquea. Se realizó una linfadenectomía lateral, que resultó incompleta. La histología mostró hallazgos compatibles con FD. La FD son tumores de proliferación lenta, no metastásicos y con una capacidad altamente invasiva que suelen estar presentes en la poliposis adenomatosa familiar (PAF)-síndrome de Gardner. Nuestro caso tenía antecedentes de poliposis colónica masiva y familiares de primer grado de cáncer colorrectal.
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  • 文章类型: Case Reports
    纤维样型纤维瘤病(DF)是一种罕见的软组织肉瘤亚型,最常见于前腹壁。当发生在腹膜后,DF通常是家族综合征的一部分,但很少偶发性。这使得必须报告DF的任何经验实例以及不同管理方法的肿瘤学结果。我们报告了两例在我们机构的腹膜后发生的散发性和严重的DF。
    第一个病例是一名男性,表现为尿路梗阻症状,并接受了延伸到左肾的肿瘤的手术切除。第二例是一名女性,有大腿复发性纤维瘤的病史,并在影像学上偶然诊断为腹膜后DF。她接受了肿瘤切除和放疗;然而,肿瘤复发并伴有尿路梗阻症状,需要再次手术切除。两种情况的组织病理学特征和放射学成像如下所述。
    纤维瘤经常复发,从而显著影响生活质量,这反映在我们的一个案例中。手术仍然是主要的治疗手段,本报告中提出的这两个病例都需要手术切除肿瘤作为对症和治愈措施。
    腹膜后DF是一种罕见的实体,我们的案例增加了关于这个主题的稀缺文献,这很可能有助于制定针对这种罕见的DF变体的实践改变建议和指南。
    Desmoid-type fibromatosis (DF) is a rare subtype of soft tissue sarcomas that most commonly occurs in the anterior abdominal wall. When occurring in the retroperitoneum, DF is usually part of familial syndromes while only rarely sporadic. This makes it imperative to report any instance of experience with DF and the oncological outcomes of the different approaches to management. We report two cases of sporadic and severe DF occurring in the retroperitoneum at our institution.
    UNASSIGNED: The first case is a male that presented with urinary obstruction symptoms and underwent surgical resection of the tumor that extended into the left kidney. The second case is a female with a history of recurrent desmoid tumors of the thigh and was incidentally diagnosed with retroperitoneal DF on imaging. She underwent tumor resection and radiotherapy; however, the tumor recurred with urinary obstruction symptoms that required another surgical resection. Histopathological characteristics and radiological imaging of both cases are described below.
    UNASSIGNED: Desmoid tumors often recur, thus significantly influencing the quality of life which is reflected in one of our cases. Surgery remains a mainstay treatment, and both cases presented in this report required surgical resection of the tumors as symptomatic and curative measures.
    UNASSIGNED: Retroperitoneal DF is a rare entity, and our cases add to the scarce literature available on the topic, which may well contribute to the formulation of practice-changing recommendations and guidelines focused on this rare variant of DF.
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  • 文章类型: Journal Article
    腹膜后纤维瘤病是一种罕见的良性间充质肿瘤,由于肌膜膜间质内的成纤维细胞增殖而发展。作者介绍了一名41岁的男性患者,该患者因腹膜后肿瘤而转诊。做了肠系膜肿块穿刺活检,显示低度梭形细胞病变,与纤维瘤病一致。
    Retroperitoneal desmoid-type fibromatosis is a rare benign mesenchymal neoplasm that develops as a result of fibroblastic proliferation within the musculoaponeurotic stroma. The authors present the case of a 41-year-old male patient who was referred for a retroperitoneal neoplasm. A mesenteric mass core biopsy was done, and it revealed a low-grade spindle cell lesion consistent with desmoid fibromatosis.
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  • 文章类型: Case Reports
    纤维瘤是罕见的软组织肿瘤,生长缓慢,复发率高。它们通常偶尔出现在腹壁或腹膜后,在创伤和手术后报告了一些罕见的病例。成人术后硬纤维瘤非常罕见,仅有7例报告涉及椎旁位置。这是首例男性患者术后椎旁硬纤维瘤的报道。
    Desmoid tumors are rare soft tissue tumors with slow growth and high recurrence rates. They typically arise sporadically in the abdominal wall or retroperitoneum, with a few rare cases reported after trauma and surgery. Postoperative desmoid tumors in adults are very rare with only 7 reported cases involving the paraspinal location. This is the first reported case of a male patient with a postoperative paraspinal desmoid tumor.
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  • 文章类型: Case Reports
    肠系膜纤维瘤病是一种局部侵袭性肌纤维母细胞增生,很少转移到其他器官。由肠系膜纤维瘤病引起的中空器官穿孔和急性弥漫性腹膜炎很少发生。在这里,我们报告一例巨大的肠系膜纤维瘤病,主诉阵发性上腹痛,CT扫描显示有巨大的肿块,气腹和腹水。紧急剖腹手术显示空肠有腹内肿块和穿孔。术后组织学证实为肠系膜纤维瘤病。经过一年的随访,患者无复发。我们希望分享我们对这个有趣病例的治疗经验,因为它不属于典型类型,但表现为急性弥漫性腹膜炎,全切除和R0切缘是治疗急性病例的关键。迄今为止,这种非典型的文献尚未报道。
    Mesenteric fibromatosis is a locally invasive myofibroblastic proliferation and rarely metastasize to other organs. Hollow organ perforation and acute diffuse peritonitis caused by mesenteric fibromatosis rarely occurred. Here we report a case of huge mesenteric fibromatosis who complained a paroxysmal epigastric pain, and CT scan showed a huge mass, pneumoperitoneum and ascites. An urgent laparotomy showed an intro-abdominal mass and perforation locating at the jejunum. Postoperative histology confirmed it to be mesenteric fibromatosis. With one-year follow-up, the patient had no recurrence. We wish to share our treating experience of this interesting case because it did not belong to a typical type but presenting with acute diffuse peritonitis, and total resection and R0 margin is a key to treat acute case. This atypical one has not been reported in the literature till now.
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  • 文章类型: Case Reports
    纤维瘤很少见,即使在完全切除后,局部侵袭性良性肿瘤的复发率也很高。只有百分之二十是胸腔内的,它们通常是无痛的或最小的疼痛,生长缓慢。它们很少能迅速生长,模仿恶性肿瘤.这里我们介绍了一个罕见的快速增长的案例,模仿老年男性前吸烟者肺部恶性肿瘤的胸内纤维瘤。该病例证明了在肺部肿块的鉴别诊断中包括纤维瘤的重要性,提高对良性肿瘤模仿恶性行为的认识,并强调及时随访和早期诊断的潜在益处。
    Desmoid tumors are rare, locally aggressive benign tumors with a high rate of recurrence even after complete resection. Only twenty percent are intrathoracic and they are often painless or minimally painful with slow growth. Rarely they can grow quite rapidly, mimicking a malignant tumor. Here we present a rare case of a rapidly growing, intrathoracic desmoid tumor mimicking lung malignancy in an elderly male ex-smoker. This case demonstrates the importance of including desmoid tumors in the differential diagnosis of lung masses, raising awareness of benign tumors mimicking malignant behavior, and emphasizing the potential benefit of timely follow-up and early diagnosis.
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