中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2008年
4期
380-381
,共2页
侵袭性纤维瘤病%纤维肉瘤%放射治疗
侵襲性纖維瘤病%纖維肉瘤%放射治療
침습성섬유류병%섬유육류%방사치료
Aggressive fibromatosis%Fibrosarcoma%Radiation therapy
目的 探讨侵袭性纤雏瘤病的临床表现、病理特点、治疗及促使其恶变为纤维肉瘤的相关因素.方法 报告1例上肢侵袭性纤维瘤病恶变为纤维肉瘤的临床资料并复习相关文献.结果 侵袭性纤维瘤病是一种介于良性和恶性之间的纤维增生性肿瘤,具有局部漫润性和破坏性生长的生物特性;病理学表现为成纤维细胞单克隆性增生,由分化良好的成纤维细胞和肌成纤维细胞组成,缺乏恶性细胞学特征,电镜下见多形态细胞被增生的胶原网包绕,免疫组化波形蛋白和肌动蛋白阳性;手术切除为主要治疗措施,术后复发率高迭10%～70%,因此多数患者需多次手术并配合放射治疗和化学治疗;本例患者接受手术切除并经放射治疗1疗程后的13个月时复发,再次手术病理示纤维肉瘤.结论 侵袭性纤维瘤病是一种少见的纤维增生性肿瘤,其治疗以手术切除为主,具有高度复发倾向,术后常需配合放射治疗、化学治疗,向纤维肉瘤转变罕见,手术刺激、放射治疗可能是促使其恶变的主要因素.
目的 探討侵襲性纖雛瘤病的臨床錶現、病理特點、治療及促使其噁變為纖維肉瘤的相關因素.方法 報告1例上肢侵襲性纖維瘤病噁變為纖維肉瘤的臨床資料併複習相關文獻.結果 侵襲性纖維瘤病是一種介于良性和噁性之間的纖維增生性腫瘤,具有跼部漫潤性和破壞性生長的生物特性;病理學錶現為成纖維細胞單剋隆性增生,由分化良好的成纖維細胞和肌成纖維細胞組成,缺乏噁性細胞學特徵,電鏡下見多形態細胞被增生的膠原網包繞,免疫組化波形蛋白和肌動蛋白暘性;手術切除為主要治療措施,術後複髮率高迭10%～70%,因此多數患者需多次手術併配閤放射治療和化學治療;本例患者接受手術切除併經放射治療1療程後的13箇月時複髮,再次手術病理示纖維肉瘤.結論 侵襲性纖維瘤病是一種少見的纖維增生性腫瘤,其治療以手術切除為主,具有高度複髮傾嚮,術後常需配閤放射治療、化學治療,嚮纖維肉瘤轉變罕見,手術刺激、放射治療可能是促使其噁變的主要因素.
목적 탐토침습성섬추류병적림상표현、병리특점、치료급촉사기악변위섬유육류적상관인소.방법 보고1례상지침습성섬유류병악변위섬유육류적림상자료병복습상관문헌.결과 침습성섬유류병시일충개우량성화악성지간적섬유증생성종류,구유국부만윤성화파배성생장적생물특성;병이학표현위성섬유세포단극륭성증생,유분화량호적성섬유세포화기성섬유세포조성,결핍악성세포학특정,전경하견다형태세포피증생적효원망포요,면역조화파형단백화기동단백양성;수술절제위주요치료조시,술후복발솔고질10%～70%,인차다수환자수다차수술병배합방사치료화화학치료;본례환자접수수술절제병경방사치료1료정후적13개월시복발,재차수술병리시섬유육류.결론 침습성섬유류병시일충소견적섬유증생성종류,기치료이수술절제위주,구유고도복발경향,술후상수배합방사치료、화학치료,향섬유육류전변한견,수술자격、방사치료가능시촉사기악변적주요인소.
Objective To determine the clinical manifestation,pathologic behavior,therapy and related factors of rare aggressive fibromatosis.Methods Canceration from aggressive fibromatosis to fibrosarcoma in one case of aggressive fibromatosis was analyzed and relevant literatures were reviewed.Results Aggressive fibromatosis was a benign or semimaligrant,non-metastatic proliferations of fibrous tissue that infiltrated surrounding tissues and tended to recur after surgical resection.Pathology showed fibroblastic monoconal proliferation between the cellular center and the collagen periphery.Electron microscope showed an abundant collagen network enclosing a pelymorphous cellular proliferation.Immunohistochemistry defined vimentin and actin positive desmoid tumors.Complete surgical excision was a chief treatment.Several operations were needed in most cases.Recurrence rates may be as high as 10%～70%.Chemotherapy and radiotherapy may be used together with surgery in recurrence or unsatisfactory surgical margin.The disease recurred after operation and one radiation therapy,reoperation and pathology showed fibrosarcoma.Conclusion Aggressive fibromatosis is a rare benign,non-metastatic proliferation tumour of fibrous tissue with a tendency of local recurrent after surgical resection.The cornerstone of therapy is surgery.Radiation therapy and chemotherapy can be used as adjuvant therapy.It is scarce that aggressive fibromatosis cancerates to fibrosarcoma.Maybe surgical stimulus and radiation therapy are the main factors to promote it to cancerate.
