背景:血管平滑肌瘤是一种良性软组织肿瘤,起源于血管中膜的平滑肌细胞。尽管这些肿瘤最常见的位置是子宫壁,它们也可以起源于下肢。总之,这些肿瘤占足踝区肿瘤总数的0.2%。足部血管平滑肌瘤的体征和症状可能是局部疼痛,肿胀,和功能损害。迄今为止,文献中仅报道了病例报告和小人群病例系列来描述这些肿瘤的临床表现和手术治疗的有效性.在这项研究中,我们报告了足血管平滑肌瘤的手术治疗结果。
方法:2017年1月至2022年1月期间,13例足部血管平滑肌瘤患者在我院接受了手术切除。对于每种情况,我们记录了术前和术后症状,根据肌肉骨骼肿瘤协会评分(MSTS)和美国骨科足踝协会评分(AOFAS),术前和术后功能状态。报告最终并发症和局部复发。
结果:每个患者在手术治疗前至少有轻微疼痛。术前平均MSTS和AOFAS分别为22.1和76.8。平均肿瘤大小为17.7mm。术前,每位患者均接受了宽切缘切除术.在最近的随访中,没有人出现局部复发或重大并发症。手术后,术后平均MSTS和AOFAS分别增加至29.5和98.8.每个病例在手术后都有明显的功能增强和疼痛减轻。
结论:我们的结果表明,鉴于局部复发的风险极低,并且由于治疗后可以获得良好的术后疼痛缓解和功能恢复,手术切除肿瘤应被认为是治疗足血管平滑肌瘤的安全可靠的治疗方法。
BACKGROUND: Angioleiomyoma is a benign soft-tissue tumor that arises from the smooth muscle cells in the tunica media of the blood vessels. Although the most common location for these neoplasms is the uterine wall, they can also originate from lower limbs. Altogether, these neoplasms account for 0.2% of all those located in the foot and ankle region. Signs and symptoms of foot angioleiomyoma can be a localized pain, swelling, and functional impairment. To date, only
case reports and
case series with small populations have been reported in the literature to describe the clinical picture of these neoplasms and the effectiveness of surgical treatment. In this study, we report our results of surgical treatment for angioleiomyomas of the foot.
METHODS: Thirteen cases suffering from angioleiomyoma of the foot underwent surgical resection in our institution between January of 2017 and January of 2022. For each
case, we recorded preoperative and postoperative symptoms, and their preoperative and postoperative functional status according to both Musculoskeletal Tumor Society Score (MSTS) and American Orthopedic Foot and Ankle Society Score (AOFAS). Eventual complications and local recurrence were reported.
RESULTS: Each patient had at least mild pain before surgical treatment. The mean preoperative MSTS and AOFAS were 22.1 and 76.8, respectively. The mean tumor size was 17.7mm. Preoperatively, each patient underwent resection with wide margins. None had local recurrences or major complications at their latest follow-up. After surgery, the mean postoperative MSTS and AOFAS increased to 29.5 and 98.8, respectively. Each
case had a marked increment of their functionality and a reduction of their pain after surgery.
CONCLUSIONS: Our results suggest that surgical approach with tumor resection should be considered a safe and reliable treatment for foot angioleiomyomas in light of the extremely low risk of local recurrence and because of the good postoperative pain relief and functional restoration that can be obtained after the treatment.