Fibromatosis, Aggressive

纤维瘤病,好斗
  • DOI:
    文章类型: Journal Article
    一名50多岁的男子在胸部X射线上出现异常阴影,被诊断出患有后纵隔肿瘤,与以前的胸部X射线相比,该肿瘤已经长大。计算机断层扫描显示5.7×3.9厘米的固体肿块,后纵隔表面光滑。怀疑有神经源性肿瘤,纵隔肿瘤通过开胸手术切除,因为它具有很强的粘附性。术后病程良好,术后第3天出院。与术前预期相反,病理诊断为硬纤维瘤。术后6个月无任何并发症,未观察到复发.
    A man in his 50s who presented an abnormal shadow on chest X-ray was diagnosed with posterior mediastinal tumor that had grown compared to the previous chest X-ray. Computed tomography showed a 5.7×3.9 cm solid mass with a smooth surface in the posterior mediastinum. A neurogenic tumor was suspected, and the mediastinal tumor was resected through thoracotomy because it was strongly adherent. The postoperative course was good, and he was discharged from the hospital on postoperative day 3. Contrary to preoperative expectations, the tumor was pathologically diagnosed as a desmoid tumor. After 6 months postoperatively without any complications, no recurrence was observed.
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  • DOI:
    文章类型: Case Reports
    纤维瘤病是一种相对罕见的疾病,常伴有家族性腺瘤性息肉病和腹部手术史。一名43岁的男性患者出现腹痛,对比增强CT显示下腹部有肿块。肿块呈4×4×3厘米白色,具有嗜酸性粒细胞纺锤形细胞的花环状排列的致密肿瘤。免疫染色显示KIT(-),CD34(-),desmin(-),β-连环蛋白(+),SMA(几个+),诊断为纤维瘤样纤维化。手术后六个月,无明显复发.
    Desmoid-type fibromatosis is a relatively rare disease, often associated with familial adenomatous polyposis and a history of abdominal surgery. A 43-year-old male patient presented with abdominal pain and contrast-enhanced CT showed a mass in the lower abdomen. The mass was a 4×4×3 cm white, dense tumor with a wreath-like arrangement of eosinophilic spindle-shaped cells. Immunostaining showed KIT(-), CD34(-), desmin(-), β-catenin(+), SMA(few+), and the diagnosis was desmoid-type fibrosis. Six months after surgery, there was no apparent recurrence.
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  • 文章类型: Case Reports
    纤维瘤是由筋膜和肌肉-腱膜结构引起的软组织肿瘤。这些肿瘤具有局部侵袭性,复发率高,即使在完全切除后。我们介绍了一名女性患有巨大的胸内硬纤维瘤的病例。她接受了完整的手术切除,没有疾病复发。纤维瘤的自然史并不明确,通常是神秘的,使这些肿瘤难以管理。目前,胸内硬纤维瘤,医疗是推荐的方法,然而,手术可以考虑在选定的患者。
    Desmoid tumors are soft tissue neoplasms arising from fascial and muscle-aponeurotic structure. These tumors are locally aggressive and have a high recurrence rate, even after complete resection. We present the case of a female with a giant intrathoracic desmoid tumor. She underwent complete surgical resection with no disease recurrence. Desmoid tumors\' natural history is not well defined and is often enigmatic, making these tumors difficult to manage. Currently, for intrathoracic desmoid tumors, medical treatment is the recommended approach, nevertheless, surgery can be considered in selected patients.
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  • 文章类型: Multicenter Study
    背景:精准手术在骨科肿瘤学领域变得越来越重要。图像引导经皮冷冻手术(CRA)已成为腹外硬纤维瘤(EDT)的有效治疗方式。迄今为止,大多数CRA程序使用基于CT的指导,无法正确表征肿瘤节段。然而,计算机引导的MRI导航可以解决这个问题,缺乏固定的注册地标仍然是一个挑战。成功的CRA与术中成像指导促进的精确方法直接相关。这是第一项尝试评估使用皮肤基准标记来克服基于MRI的导航CRA用于有症状或进行性EDT的挑战的新方法的可行性和有效性的研究。
    方法:在2018年至2020年进行的这项回顾性研究中,使用术中MRI导航对单个中心有症状或进行性EDT的11例患者进行了CRA治疗。进行了15次冷冻手术,每个人都坚持个性化的术前计划。肿瘤总大小,手术前和手术后可行和不可行部分,记录评价主观健康状况的SF-36问卷。
    结果:所有CRA均表现出对预定计划的100%依从性。总的来说,肿瘤大小减小,中位数=-56.9%[-25.6,-72.4]),活组织减少,(中位数=-80.4%[-53.3,-95.2])。四名患者需要额外的CRA。只有一名患者的肿瘤没有缩小。1例患者出现局部肌肉坏死。操作前,平均身体和心理得分分别为41.6[29.4,43]和26.3[17.6,40.9]。手术后,平均身心得分分别为53.4[38,59.7]和38[31.2,52.7]。
    结论:这些发现为使用皮肤基准标记配准进行经皮冷冻手术的可行性和有效性提供了早期指示,用于MRI计算机导航以安全地治疗EDT。需要更大的队列和多中心评估来确定该技术的功效。
    BACKGROUND: Precision surgery is becoming increasingly important in the field of Orthopaedic Oncology. Image-guided percutaneous cryosurgery (CRA) has emerged as a valid treatment modality for extra-abdominal desmoid tumors (EDTs). To date, most CRA procedures use CT-based guidance which fails to properly characterize tumor segments. Computer-guided MRI navigation can address this issue however, the lack of a fixed landmark for registration remains a challenge. Successful CRA correlates directly with precision approaches facilitated by intraoperative imaging guidance. This is the first study that attempts to assess the feasibility and efficacy of a novel approach of using skin fiducial markers to overcome the challenge of a MRI-based navigation CRA for symptomatic or progressive EDTs.
    METHODS: In this retrospective study conducted between 2018 and 2020, 11 patients at a single center with symptomatic or progressive EDTs were treated with CRA using intraoperative MRI navigation. Fifteen cryosurgery procedures were performed, each adhering to a personalized pre-operative plan. Total tumor size, viable and non-viable portions pre- and post-operation, and SF-36 questionnaire evaluating subjective health were recorded.
    RESULTS: All CRAs demonstrated 100% adherence to the predetermined plan. Overall, tumor size decreased Median= -56.9% [-25.6, -72.4]) with a reduction in viable tissue, (Median= -80.4% [-53.3, -95.2]). Four patients required additional CRAs. Only one patient\'s tumor did not reduce in size. One patient suffered from local muscle necrosis. Pre-operation, the average physical and mental scores 41.6 [29.4, 43] and 26.3 [17.6, 40.9] respectively. Post-operation, the average physical and mental scores were 53.4[38, 59.7] and 38 [31.2, 52.7] respectively.
    CONCLUSIONS: These findings provide an early indication of the feasibility and efficacy of performing percutaneous cryosurgery using skin fiducial marker registration for MRI-computed navigation to treat EDTs safely. Larger cohorts and multicenter evaluations are needed to determine the efficacy of this technique.
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  • DOI:
    文章类型: Review
    病人是一名27岁的男子。他被转诊到我们医院,因为他知道腹部有肿块。腹部超声显示70毫米的肿块病变。增强的计算机断层扫描显示70毫米的肿块,边缘清晰,近端空肠附近的内部增强不均匀。患者被诊断为十二指肠或小肠原发性粘膜下肿瘤,并计划手术来诊断和治疗肿瘤。肿瘤位于空肠上肠系膜,肿瘤切除和部分小肠切除。组织病理学检查显示梭形细胞增殖,无核分裂,和组织中混合的胶原纤维。免疫组织化学显示β-catenin(+),SMA(+),AE1/AE3(-),KIT(-),CD34(-),S-100(-)。基于这些发现,我们诊断为原发性小肠系膜纤维瘤病。在这份报告中,我们描述了一例原发性小肠系膜纤维瘤病,并回顾了文献。
    The patient was a 27-year-old man. He was referred to our hospital because he was aware of a mass in his abdomen. An abdominal ultrasound showed a 70-mm mass lesion. Enhanced computed tomography showed a 70-mm mass with well- defined margins and heterogeneous internal enhancement near the proximal jejunum. The patient was diagnosed with a suspected primary submucosal tumor of the duodenum or small intestine, and surgery was planned to diagnose and treat the tumor. The tumor was located in the upper jejunal mesentery, and tumor resection and partial small bowel resection were performed. Histopathological examination revealed proliferation of spindle-shaped cells without karyomitosis, and mixed collagen fibers in the tissue. Immunohistochemistry showed β-catenin(+), SMA(+), AE1/AE3(-), KIT(-), CD34(-), and S-100(-). Based on these findings, we diagnosed primary desmoid fibromatosis of the small intestinal mesentery. In this report, we describe a case of primary desmoid fibromatosis of the small intestinal mesentery with a review of the literature.
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  • 文章类型: Case Reports
    纤维瘤病,或者硬纤维瘤,其特征在于源自腱膜肌结构的结缔组织的过度和浸润性增殖。乳腺纤维瘤病在人类和动物中很少见,其确切病因尚不清楚。一只10岁的混血母犬在右颅胸乳腺(M1)中出现肿块,并进行了肿块切除术。质量是坚定的,具有不规则的表面和明显的界限。微观上,它是梭形细胞的肿瘤增殖,具有低异型性,散布着丰富的致密胶原组织,通过Gomori三色和Masson三色的组织化学染色以及波形蛋白和平滑肌肌动蛋白的免疫阳性证实,确认乳腺纤维瘤病.狗的乳腺纤维瘤病需要进一步研究以阐明其临床,流行病学和致病因素。
    Fibromatosis, or desmoid tumour, is characterized by excessive and infiltrative proliferation of connective tissue originating from aponeurotic muscle structures. Mammary fibromatosis is rare in humans and animals and its precise aetiology is unknown. A 10-year-old mixed-breed female dog developed a mass in the right cranial thoracic mammary gland (M1) and underwent lumpectomy. The mass was firm, with an irregular surface and distinct limits. Microscopically, it was a neoplastic proliferation of fusiform cells with low atypia, interspersed with abundant dense collagenous tissue, confirmed by histochemical staining with Gomori\'s trichrome and Masson\'s trichrome and immunopositivity for vimentin and smooth muscle actin, confirming mammary fibromatosis. Mammary fibromatosis in dogs needs further studies to elucidate its clinical, epidemiological and aetiopathogenic aspects.
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  • 文章类型: Review
    背景:纤维瘤(DF)是一种以肌成纤维细胞和成纤维细胞的强克隆性增殖为特征的疾病。我们描述了一个模仿乳腺肿瘤的DF病例,同时回顾了临床表现的文献,诊断过程,以及这种战斗疾病的治疗过程。
    方法:一名34岁女性患者,在左乳房上象限的交界处有乳房肿块。DF诊断后,决定进行与象限后重建相关的左乳房切片切除术,免疫组织化学和结果与DF相容。
    结论:临床表现为实性肿块,通常无痛,偶尔粘附在胸壁上。每个患者的治疗策略应该是理想化的。因此,有可能进行根治性手术切除和/或放疗,手术后可进行放疗。
    BACKGROUND: Desmoid fibroma (DF) is a disorder characterized by strong clonal proliferation of myofibroblasts and fibroblasts. We describe a case of DF that mimicked a breast tumor, along with a review of the literature on the clinical manifestation, diagnostic process, and course of therapy for this combative disease.
    METHODS: A 34-year-old female patient with breast lump at the junction of the upper quadrants of the left breast. After the diagnosis of DF, it was decided to perform a sectorectomy of the left breast associated with post-quadrant reconstruction, with immunohistochemistry and findings compatible with DF.
    CONCLUSIONS: Clinically manifests as a solid mass that is often painless and occasionally adherent to the chest wall. A treatment strategy should be idealized for each patient. Thus, there is the possibility of performing radical surgery for resection and/or radiotherapy, and surgery may be followed by radiotherapy.
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  • 文章类型: Review
    Wiskott-Aldrich综合征(WAS)是一种X连锁的隐性原发性免疫缺陷疾病,以严重的湿疹为特征,反复感染,和微血小板减少症。异基因造血干细胞移植(HSCT)是经典形式患者的潜在治愈性治疗选择。与其他先天性免疫错误(IEI)相比,患有WAS的患者发生移植后肿瘤的风险似乎更高。但是实际的发病率没有很好的定义,由于公布数据的稀缺性。
    这里,我们描述了一名10岁的患者被诊断患有WAS,在生命的第一年接受HSCT治疗,他随后发展了两个罕见的实体瘤,血管内皮瘤和硬纤维瘤。已对WAS患者中HSCT后肿瘤的文献进行了综述。
    该患者在2个月大时接受了经典WAS的诊断(朱评分=3),通过WAS基因测序证实,检测到无义半合子c.37C>T(Arg13X)突变。9个月时,患者接受了来自匹配的无关供体的HSCT,并具有足够的免疫重建,以正常淋巴细胞亚群和丝裂原增殖试验为特征。血小板计数明显增加,即使血小板计数从未达到参考值。还检测到混合嵌合现象,单核细胞上有残留的WASP-群体(27.3%)。该患者在5岁时发展为kaposiform血管内皮瘤。发现了第二个腹部肿瘤,当他达到10岁时,在组织学上被分类为硬纤维瘤。在HSCT后的长期WAS幸存者中发现了造血和实体瘤。
    这里,我们描述了一例WAS患者在HSCT后发展为两种罕见的实体瘤.在HSCT后WAS患者的长期随访中,有必要对肿瘤风险进行积极的监测计划。
    Wiskott-Aldrich syndrome (WAS) is an X-linked recessive primary immunodeficiency disorder characterized by severe eczema, recurrent infections, and micro-thrombocytopenia. Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapeutic option for patients with classic form. The risk of developing post-transplant tumors appears to be higher in patients with WAS than in other inborn errors of immunity (IEIs), but the actual incidence is not well defined, due to the scarcity of published data.
    Herein, we describe a 10-year-old patient diagnosed with WAS, treated with HSCT in the first year of life, who subsequently developed two rare solid tumors, kaposiform hemangioendothelioma and desmoid tumor. A review of the literature on post-HSCT tumors in WAS patients has been performed.
    The patient received diagnosis of classic WAS at the age of 2 months (Zhu score = 3), confirmed by WAS gene sequencing, which detected the nonsense hemizygous c.37C>T (Arg13X) mutation. At 9 months, patient underwent HSCT from a matched unrelated donor with an adequate immune reconstitution, characterized by normal lymphocyte subpopulations and mitogen proliferation tests. Platelet count significantly increased, even though platelet count never reached reference values. A mixed chimerism was also detected, with a residual WASP- population on monocytes (27.3%). The patient developed a kaposiform hemangioendothelioma at the age of 5. A second abdominal tumor was identified, histologically classified as a desmoid tumor when he reached the age of 10 years. Both hematopoietic and solid tumors were identified in long-term WAS survivors after HSCT.
    Here, we describe the case of a patient with WAS who developed two rare solid tumors after HSCT. An active surveillance program for the risk of tumors is necessary in the long-term follow-up of post-HSCT WAS patients.
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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
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