背景:皮肤纤维瘤(DF)是一种常见的良性软组织肿瘤。它发生在身体的任何地方,但常见于上肢和下肢。它经常出现在年轻人到中年人中,主要在女性中。
方法:对在6年期间诊断和治疗的31例足踝部DF患者进行了表征。
结果:患者(16名男性,15名女性)年龄在7至75岁之间(平均,55年)。临床上,17名患者出现疼痛症状,14个是无痛的。严重的,DF表现为凸起的红色,粉色,棕褐色,或肤色的软团。肿瘤大小为0.3~1.5cm(平均,直径0.67厘米)。26个DFs(84%)位于足和脚踝的背侧表面,在足底方面发现了五个(16%)。18例患者手术切除肿瘤(>0.5cm),13例患者由于这些病变的体积较小(≤0.5cm)和良性性质,在穿刺活检后进行了观察性随访。进一步随访发现只有1例(3.2%)患者局部复发,手术切除后37个月,完全切除了。组织学上,DF的特征是梭形成纤维细胞和组织细胞的增殖,以模糊的束状模式,和增厚的胶原蛋白束。
结论:足部和踝部皮肤纤维瘤主要发生于50多岁的患者,没有性别优势。需要通过组织学分析和XIIIa因子免疫染色与其他良性和恶性肿瘤区分开来,CD68和其他生物标志物。治疗选择包括手术切除或活检后观察性随访,取决于临床特征和对功能活动的影响。
BACKGROUND: Dermatofibroma (DF) is a common benign soft-tissue tumor. It occurs anywhere on the body but is commonly seen on the upper and lower extremities. It is frequently found in young to middle-aged adults and predominantly in females.
METHODS: Thirty-one patients with DF on the foot and ankle diagnosed and treated during a 6-year period were characterized.
RESULTS: The patients (16 males, 15 females) were aged 7 to 75 years (average, 55 years). Clinically, 17 patients noted painful symptoms, and 14 were painless. Grossly, DF manifested as a raised red, pink, tan, or skin-colored soft mass. The tumor size ranged from 0.3 to 1.5 cm (average, 0.67 cm in diameter). Twenty-six DFs (84%) were localized on the dorsal surface of the foot and ankle, and five (16%) were found on the plantar aspect. Eighteen patients were treated by surgical excision of the tumor (>0.5 cm), and 13 patients had observational follow-up after punch biopsy due to the small size (≤0.5 cm) and benign nature of these lesions. Further follow-up found that only one patient (3.2%) had a local recurrence, 37 months after surgical excision, which was completely reexcised. Histologically, DF is characterized by proliferation of spindle fibroblasts and histiocytes, in a vague fascicular pattern, and thickened collagen bundles.
CONCLUSIONS: Dermatofibroma on the foot and ankle predominantly occurs in patients in their 50s, without a preponderance by sex. It needs to be differentiated from other benign and malignant tumors with histologic analysis and immunostaining with factor XIIIa, CD68, and other biomarkers. Treatment options include either surgical excision or observational follow-up after biopsy, depending on the clinical characteristics and effect on functional activity.