aggressive fibromatosis

侵袭性纤维瘤病
  • 文章类型: Case Reports
    纤维瘤(DTs)是罕见的良性肿瘤,但由于其局部浸润性和复发倾向而导致大量死亡。大多数DT发生在四肢和躯干。头颈部DTs并不常见,但对患者的面部外观有显著影响。然而,关于位于头颈部的多个DTs的诊断和治疗的信息有限.我们报告了一名14岁男孩中的第一例多发性颌面DTs。他有三个月的无痛性颌下肿块,MRI成像显示颌下和双侧zu区异常高信号。考虑到面部美学,通过口内切口,我们从最大的肿块获得了活检。病理检查证实了DT的诊断。我们选择了观望策略,并对其余群众进行了临床监测。在随后的1年随访中,群众停滞不前,似乎渐行渐远。根据此案的发展和结果,建议对颅面DTs进行保守治疗;但是,未来对更大的患者队列进行前瞻性研究,可以更清楚地了解治疗和预后.
    Desmoid tumors (DTs) are rare benign neoplasms but cause significant mortality due to their locally infiltrative nature and propensity to recur. Most DTs occur in the extremities and trunk. Head and neck DTs are uncommon but can have a significant impact on a patient\'s facial appearance. However, there is limited information available about the diagnosis and treatment for multiple DTs located in head and neck. We report the first case of multiple maxillofacial DTs in a 14-year-old boy. He had painless submandibular masses for three months and MRI imaging reveals abnormal high signals on the submandibular and bilateral zygomatic regions. Considering facial aesthetics, via intraoral incision we obtained a biopsy from the largest mass. Pathological examination confirmed a diagnosis of DT. We selected the wait-and-see strategy and clinically monitored the rest of the masses. During the subsequent 1-year follow-up, the masses were stagnant and appeared to involute. According to the development and outcome of this case, a conservative treatment for craniofacial DTs is suggested; however, greater clarity concerning management and prognosis could derive from prospective study of a larger patient cohort in the future.
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  • 文章类型: Case Reports
    纤维瘤病(DF)的特征是罕见的单克隆成纤维细胞增殖,表现出可变且不可预测的临床表现。DF可分为散发性和遗传性。尽管进行了广泛的研究,DF的确切病因仍然难以捉摸。
    一名31岁的男性患者出现在医院,右下腹部肿块逐渐增大,伴有腹部不适。入院前1周发现症状。肠镜检查没有发现结肠异常,血液检查没有任何异常。由于手术过程中质量的不确定性,部分切除回肠和盲肠,然后是回肠结肠端对端吻合术,术后无并发症。最终的病理诊断证实远端回肠的原发性纤维样型纤维瘤病(侵袭性纤维瘤病)。为了有效地管理DF,我们建议对患者进行随访.这包括手术后第一年每3个月预约一次,其次是每6个月的任命,直到第五年,此后每年一次.随访检查应包括收集患者的病史,体检,验血,超声波,CT扫描,以及其他相关评估。在后续行动的第一年,没有进行进一步的治疗,患者保持无病。
    起源于小肠的纤维瘤病(DF)是一种极为罕见的疾病,表现出局部侵袭性,可能危及生命。尽管它的组织学是良性的,DF具有高的局部复发率并且缺乏转移潜力。DF的诊断仍然具有挑战性,特别是在由于无症状患者或部分器官受损而导致手术干预不可行的情况下。在这种情况下,建议采用“观察等待”方法作为初始治疗策略。然而,当术前诊断困难时,手术通常被认为是最好的选择。鉴于局部复发的可能性和不确定的长期预后,定期跟进是必要的。
    UNASSIGNED: Desmoid-type fibromatosis (DF) is characterized by a rare monoclonal fibroblast proliferation that exhibits variable and unpredictable clinical presentation. DF can be classified into sporadic and hereditary types. Despite extensive research efforts, the exact etiology of DF remains elusive.
    UNASSIGNED: A 31-year-old male patient presented to the hospital with a progressively growing mass in the right lower abdomen, accompanied by abdominal discomfort. Symptoms are discovered 1 week before admission. Enteroscopy revealed no evidence of colonic abnormalities, and blood tests did not indicate any abnormalities. Due to the indeterminate nature of the mass during surgery, a partial resection of the ileum and cecum was performed, followed by ileocolonic end-to-end anastomosis, with no postoperative complications. The final pathological diagnosis confirmed primary desmoid-type fibromatosis of the distal ileum (invasive fibromatosis). To effectively manage DF, we recommend a follow-up schedule for patients. This includes appointments every 3 months in the first year following surgery, followed by appointments every 6 months up to the fifth year, and then once a year thereafter. The follow-up examinations should include collection of the patient\'s medical history, physical examination, blood tests, ultrasounds, CT scans, and other relevant assessments. During the first year of the follow-up period, no further treatment was administered, and the patient remained disease-free.
    UNASSIGNED: Desmoid-type fibromatosis (DF) originating from the small intestine is an extremely rare condition that exhibits local invasiveness and can be life-threatening. Despite its benign histology, DF has a high local recurrence rate and lacks metastatic potential. Diagnosis of DF remains challenging, especially in cases where surgical intervention is not feasible due to asymptomatic patients or partial organ impairment. In such cases, a \"watchful waiting\" approach is recommended as the initial treatment strategy. However, when preoperative diagnosis is difficult, surgery is typically considered the best option. Given the potential for local recurrence and the uncertain long-term prognosis, regular follow-up is necessary.
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  • 文章类型: Case Reports
    侵袭性纤维瘤病(AF),也被称为韧带样纤维瘤病和硬纤维瘤,是位于深层软组织中的成纤维细胞克隆增生性病变。本研究报告了一名36岁的房颤女性,她接受了颈脊髓室管膜瘤手术。AF在切口部位附近的颈部软组织中发展。颈部AF的大小在2年内迅速增加,由于不适,患者接受了初始手术切除,没有任何其他联合治疗方法.当患者在手术后6个月接受常规检查时,发现颈部房颤复发.建议手术切除及放疗。本病例报告应提高临床医生对房颤的认识。并帮助诊断过程和治疗计划。
    Aggressive fibromatosis (AF), also known as ligamentoid fibromatosis and desmoid tumor, is a fibroblast clonoproliferative lesion located in the deep soft tissue. The present study reports the case of a 36-year-old female with AF who underwent cervical spinal cord ependymoma surgery. AF developed in the soft tissue of the neck adjacent to the incision site. The size of the neck AF increased rapidly over 2 years, and due to discomfort, the patient underwent initial surgical resection without any other combined treatment methods. When the patient was routinely reviewed at 6 months post-surgery, a recurrence of AF of the neck was found. The patient was recommended surgical resection and radiotherapy. This case report should improve the understanding of clinicians with regard to AF, and help the diagnostic process and treatment plan.
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  • 文章类型: Journal Article
    目的:尽管腹壁纤维瘤病(DF)的治疗在过去的几十年中有所发展,手术治疗仍然是一个重要的方法。以前,腹部DF的手术主要通过剖腹手术进行,涉及到大量的解剖和严重的创伤。这里,我们报道了年轻女性患者腹腔镜治疗腹壁DF的单中心经验.
    方法:回顾性分析2020年1月至2022年4月山东大学齐鲁医院收治的9例腹壁DF患者的临床资料。所有患者均接受腹腔镜腹壁DF切除术和立即腹壁重建(AWR),并通过腹膜内嵌网(IPOM)技术进行网片增强。
    结果:所有患者均成功进行了腹腔镜DF切除和AWR。平均手术时间为175.56±46.20min。腹壁缺损宽度为8.61±3.30cm。全层和部分厚度肌筋膜闭合和重新逼近在五个,两个,还有两个病人,分别。平均网孔尺寸为253.33±71.01cm2。总住院时间和术后住院时间分别为11.00±3.46天和4.89±2.03天,分别。一名患者在切除20个月后肿瘤复发。尽管如此,死亡,疝气,在平均16.11±8.43个月的随访中,未观察到任何患者出现隆起或隆起.
    结论:对于年轻女性患者,腹腔镜腹壁DF切除术和IPOM网状加固的即刻AWR是安全可靠的。此类患者的管理应根据生物学行为决定,尺寸,和肿瘤的位置。
    OBJECTIVE: Although the treatment of abdominal wall desmoid-type fibromatosis (DF) has evolved over the past decades, surgical treatment remains an important approach. Previously, surgeries for abdominal DF were mostly performed by laparotomy, which involves massive dissection and significant trauma. Here, we report our single-center experience of the laparoscopic management of abdominal wall DF in young female patients.
    METHODS: The clinical data of nine patients diagnosed with abdominal wall DF during January 2020-April 2022 at the Qilu Hospital of Shandong University were retrospectively analyzed. All patients underwent laparoscopic resection of abdominal wall DF and immediate abdominal wall reconstruction (AWR) with mesh augmentation via the intraperitoneal onlay mesh (IPOM) technique.
    RESULTS: Laparoscopic DF resection and AWR were successfully performed in all patients. The mean operation time was 175.56 ± 46.20 min. The width of abdominal wall defect was 8.61 ± 3.30 cm. Full- and partial-thickness myofascial closure and reapproximation were performed in five, two, and two patients, respectively. The average mesh size was 253.33 ± 71.01 cm2. The total and postoperative lengths of hospital stay were 11.00 ± 3.46 and 4.89 ± 2.03 days, respectively. Tumor recurred in one patient after 20 months of the resection. Nonetheless, death, herniation, or bulging were not observed in any patient during a mean follow-up of 16.11 ± 8.43 months.
    CONCLUSIONS: Laparoscopic resection of abdominal wall DF and immediate AWR with IPOM mesh reinforcement is safe and reliable for young female patients. Management of such patients should be decided according to the biological behavior, size, and location of tumors.
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  • 文章类型: Case Reports
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  • 文章类型: Editorial
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  • 文章类型: Case Reports
    未经证实:巨大的腹部肿瘤伴食管裂孔疝仍然是一种罕见的疾病,关于其在麻醉中的意义的研究很少。大的食管裂孔疝可能会压迫心脏,导致心律失常,甚至心脏骤停,这大大增加了麻醉管理的风险和挑战。
    UNASSIGNED:我们介绍了一个病例,其中一名患有巨大的腹部硬纤维瘤和大的食管裂孔疝的患者在麻醉和手术过程中出现了危急情况。
    UNASSIGNED:对于麻醉医师来说,管理患者的呼吸系统和循环是一个巨大的挑战。精心的围手术期管理和优化的多学科团队是成功治疗这种罕见疾病的关键因素。此外,清醒气管插管,保留自主呼吸的通气和靶向液体治疗在麻醉管理中起着至关重要的作用.
    UNASSIGNED: A giant abdominal tumor with a large hiatal hernia remains a rare disease with few studies regarding its implications in anesthesia. A large hiatal hernia may compress the heart and cause arrhythmia and even cardiac arrest, which greatly increases the risks and challenges of anesthesia management.
    UNASSIGNED: We present a case in which a patient with a giant abdominal desmoid tumor and large hiatal hernia experienced a critical situation during anesthesia and surgery.
    UNASSIGNED: It is a great challenge for anesthesiologists to manage a patient\'s respiratory system and circulation. Careful perioperative management and optimized multidisciplinary teams are the key factors in the successful management of this rare condition. In addition, awake endotracheal intubation, ventilation preserving spontaneous breathing and target-directed fluid therapy play an essential role in anesthesia management.
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    文章类型: Journal Article
    未经评估:由于其罕见,目前缺乏针对侵袭性纤维瘤病(AF)的标准治疗指南。
    UNASSIGNED:本研究旨在探讨根治性手术切除后腹部AF复发和生存的危险因素。
    UNASSIGNED:2012年8月至2020年12月,对复旦大学附属上海公共卫生临床中心69例房颤的临床资料进行回顾性分析,肿瘤位于腹壁或腹腔。主要观察终点为无进展生存时间(PFS)和总生存时间(OS)。
    未经授权:所有69例患者均获得显微镜下R0切除,10例(14.5%)局部复发,3人(4.3%)死亡。1、3、5和10年后的PFS率为96.8%,87.7%,78.8%,78.8%,分别。1年、3年、5年和10年后的OS率为100%,100%,92.9%,和81.3%,分别。在10例复发患者中,中位复发时间为17.6个月.合并家族性腺瘤性息肉病(FAP)和既往复发史是术后复发的独立危险因素。
    未经证实:腹部房颤根治术后,局部复发率为15%。合并FAP和既往复发史是术后复发的独立危险因素。尤其是在FAP患者中,应进行R0和联合器官切除术,以最大程度地减少复发并改善预后。
    未经证实:本研究确定了房颤复发的危险因素,并建议R0切除,尤其是合并FAP患者。不应普遍实施观望策略,根治性手术将为患有此类罕见疾病的患者带来临床益处。
    UNASSIGNED: There are lacking standard treatment guidelines for aggressive fibromatosis (AF) because of its rarity.
    UNASSIGNED: This study aimed to investigate the risk factors for recurrence and survival of abdominal AF after radical surgical resection.
    UNASSIGNED: From August 2012 to December 2020, a retrospective analysis was conducted on the clinical data of 69 AF in Shanghai Public Health Clinical Center Affiliated to Fudan University, with the tumor locating either in the abdominal wall or in the abdominal cavity. The main observation end point was progression-free survival time (PFS) and overall survival time (OS).
    UNASSIGNED: All 69 patients achieved microscopic R0 resection, 10 (14.5%) had local recurrence, and 3 (4.3%) died. The PFS rate after 1, 3, 5, and 10 years was 96.8%, 87.7%, 78.8%, and 78.8%, respectively. The OS rate after 1, 3, 5, and 10 years was 100%, 100%, 92.9%, and 81.3%, respectively. In 10 patients with recurrence, the median recurrence time was 17.6 months. Concomitant familial adenomatous polyposis (FAP) and history of previous recurrence were independent risk factors of post-operative recurrence.
    UNASSIGNED: After radical surgery of abdominal AF, the local recurrence rate was 15%. Concomitant FAP and a previous history of recurrence were independent risk factors of post-operative recurrence. R0 and a combined organ resection should be performed especially in FAP patients to minimize the recurrence and improve the prognosis.
    UNASSIGNED: The present study identifies the risk factors of recurrence in AF and suggests R0 resection especially in concomitant FAP patients. A wait-and-see strategy should not be generally implemented and radical surgery will bring clinical benefits to patients with such kind of rare disease.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    纤维瘤是一种罕见的局部浸润性肿瘤。然而,复发性纤维瘤的最佳治疗策略仍存在争议.据报道,高强度聚焦超声(HIFU)是一种治疗复发性硬纤维瘤的非侵入性方法。然而,它对巨大的韧带样肿瘤或具有复杂解剖结构的肿瘤的疗效尚不清楚。
    我们开发了一种新的治疗策略,称为低功率累积HIFU,并将其应用于治疗复发性硬纤维瘤。
    我们回顾性收集了91例复发性硬纤维瘤患者的数据,这些患者在手术治疗失败后接受了低功率累积HIFU治疗。HIFU治疗的平均消融比例为69.5%,客观有效率为47.3%。这些患者的5年无进展生存率估计为69.3%。
    低功率累积HIFU治疗可取得显著疗效并长期控制复发性硬纤维瘤。
    Desmoid tumors are rare neoplasms that are locally invasive. However, optimal treatment strategies for recurrent desmoid tumors remain controversial. High-intensity focused ultrasound (HIFU) has been reported as a noninvasive modality for treating recurrent desmoid tumors. However, its efficacy against massive desmoid tumors or those with complex anatomies remains unclear.
    We developed a new therapeutic strategy called low-power cumulative HIFU and applied it to treat recurrent desmoid tumors.
    We retrospectively collected data from 91 patients with recurrent desmoid tumors who underwent low-power cumulative HIFU treatment after surgical treatment failure. The mean ablation proportion of the HIFU treatment was 69.5%, and the objective response rate was 47.3%. The 5-year estimated progression-free survival rate for these patients was 69.3%.
    Low-power cumulative HIFU treatment could achieve significant efficacy and long-term control of recurrent desmoid tumors.
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