[侵袭性纤维瘤病手术一例]。

S Yoshida, H Kimura, N Iwai, K Yasufuku, Y Yamaguchi, Y Takahara
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引用次数: 0

摘要

本文报告一例发生于后纵隔的“侵袭性纤维瘤病”。一名50岁女性因右肩疼痛入住我院。肿瘤包围右侧椎动脉,浸润右侧交感神经、臂丛和肌肉组织。经皮穿刺活检怀疑为神经源性肿瘤。1996年8月10日行肿瘤切除及部分切除侵犯椎动脉及臂丛。术后检查肿瘤大小为6.2 x 6.5 x 4.5 cm,病理诊断为“侵袭性纤维瘤病”。术后过程平稳,但轻微出现霍纳氏症状和右手IV、V、手指运动障碍。术后行60 Gy放射治疗。术后17个月无复发。本病的特点是很少转移,但有浸润性生长,术后复发是一个重要问题。特别是颈部和头部很重要,因为解剖上没有足够的手术切缘。因此,术后需要化疗或放疗。本例术后行放射治疗。手术后17个月没有复发。但是,长期随访是必要的,因为它可能在术后治疗后复发。
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[A surgical case of aggressive fibromatosis].

A case of "aggressive fibromatosis" which appeared in posterior mediastinum is reported. A 50-year-old woman was admitted to our hospital with right shoulder pain. The tumor surrounded the right vertebral artery and infiltrated into the right sympathetic nerve, brachial plexus and muscle tissue. It was suspected of neurogenic tumor by percutaneous needle biopsy. Removal of the tumor and partial resection of the invaded vertebral artery and brachial plexus were made in Aug. 10, 1996. In postoperative examination, the tumor was 6.2 x 6.5 x 4.5 cm in size and diagnosed pathologically as "aggressive fibromatosis". Postoperative course was uneventful, but Horner's symptoms and motor disturbances of IV, V, fingers of the right hand were slightly occurred. Radiotherapy of 60 Gy was done after operation. There is no recurrence to date 17 months after surgery. As for the character of this disease, it seldom metastasizes, but grows infiltratively and the recurrence after operation is an important problem. In particular, the neck and the head are important because surgical margin is not provided enough, anatomically. Therefore, chemotherapy or radiotherapy after operation is needed. In this case, radiotherapy was done after operation. So, there is not the recurrence and passes to date 17 months after surgery. But, follow-up of long terms is necessary because it may recur after postoperative therapies.

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