头颈部侵袭性纤维瘤病临床分析

Clinical analysis of aggressive fibromatosis in head and neck

目的探讨头颈部侵袭性纤维瘤病的临床病理特点、治疗方法及预后。方法：回顾性分析我院2002-01-2012-12期间经病理确诊的12例头颈部侵袭性纤维瘤病患者的临床资料和随访情况，男9例，女3例，年龄35～65岁，中位年龄58岁。结果：全部患者随访1～7年，2例术后复发。至末次随访，4例未见复发，2例带瘤生存。结论：头颈部侵袭性纤维瘤病少见，尚需结合免疫组织化学与多种肿瘤进行鉴别。CT及MRI影像学检查有助了解病变范围及性质。MRI在显示病灶向周围侵犯程度、判断疗效及术后复发方面优于CT。治疗以广泛手术切除为主，对于复发或难以彻底切除的患者可配合放疗和化疗。

Objective：To investigate the clinical features , therapeutic methods and therapeutic effects of ag- gressive fibromatosis in head and neck region. Method： Clinical data of 12 cases which were diagnosed by pathology and immmunohistochemistry from January 2002 to December 2012 were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. Result：All the patients were followed up for a period of 1 to 7 years after operation. Two cases occurred recurrence. Of these two,one underwent endoscopic surgery again , and the other underwent endoscopic-assisted surgery combined with postoperative radiotherapy. All the patients lived with no evidence of disease until the last follow-up. Conclusion：Aggressive fibromatosis in head and neck is a rare benign tumor. Corrent diagnosis depends on clinical characteristic and immunohistochemical examination. It should still be differentially diagnosed from other tumors. CT and MRI features of aggressive fibromatosisi are specific, which are valuable in the diagnosis and differential diagnosis of the lesion. MRI is superior to CT scan in defining the extent of involvement,detecting recurrence after surgery. The main treatment modality is wide surgical exci- sion of the lesion. Radiotherapy and chemotherapy can be used as adjuvant therapy in patients with recurrent or un- resectable or inoperable disease.