背景:纤维肉瘤是一种恶性肿瘤,鼻腔定位不常见。临床上,主要症状是鼻出血和鼻塞。微观上,它的特征是具有人字形模式的成纤维细胞和具有超色核的纺锤形细胞的密集增殖。
方法:我们报告了一例37岁女性的鼻纤维肉瘤,有鼻出血和鼻塞的复发病史,已有数年之久。做了活检,组织病理学发现报告了具有人字形模式的成纤维细胞和具有超色核的梭形细胞的密集增殖。免疫组织化学对Ki67,P53和波形蛋白染色呈阳性。最终诊断为鼻纤维肉瘤。该患者接受了功能性内窥镜鼻窦手术并切除了右上颌骨壁的肿瘤,右筛窦,和右额叶区域。十三个月后,患者复发。在全身麻醉下,通过鼻侧切开术和上颌骨内侧切除术采取外部入路。患者接受紫杉醇和顺铂方案化疗6个周期。
结论:在这种情况下,我们给予化疗是因为患者复发,未获得无瘤边缘,计算机断层扫描显示骨受累.
结论:鼻部纤维肉瘤是一种罕见的恶性肿瘤,可以通过其组织病理学特征和免疫组织化学来诊断。
BACKGROUND: Fibrosarcoma is a malignant neoplasm, with nasal localization uncommon. Clinically, the main symptoms are epistaxis and nasal obstruction. Microscopically, it is characterized by a dense proliferation of fibroblasts with a herringbone pattern and spindle-shaped cells with hyperchromatic nuclei.
METHODS: We report a nasal fibrosarcoma of a 37-year-old woman with a recurrent history of epistaxis and nasal obstruction for several years. A biopsy was performed, and the histopathological findings reported a dense proliferation of fibroblasts with a herringbone pattern and spindle-shaped cells with hyperchromatic nuclei. The immunohistochemistry was positive for Ki67, P53, and vimentin staining. The final diagnosis was nasal fibrosarcoma. The patient underwent functional endoscopic sinus surgery and extirpation of the tumor on the wall of the right maxilla, right ethmoid sinus, and right frontal area. Thirteen months later, the patient experienced a recurrence. An external approach was taken under general anesthesia via lateral rhinotomy with medial maxillectomy. The patient underwent chemotherapy with a regimen of paclitaxel and cisplatin for six cycles.
CONCLUSIONS: We gave chemotherapy in this
case because the patient experienced a recurrence, tumor-free margins were not obtained, and a computed tomography scan showed bone involvement.
CONCLUSIONS: Nasal fibrosarcoma is a rare malignant neoplasm, which can be diagnosed by its histopathological features and immunohistochemistry.