胸部特殊孤立性纤维瘤的外科治疗

Surgical treatment of special thoracic solitary fibrous tumors

目的:总结胸部特殊孤立性纤维瘤(solitary fibrous tumors,SFTs)的外科治疗经验。方法:回顾性分析2009年1月至2017年5月中南大学湘雅医院收治的胸部SFTs患者的临床资料,进行总结分析。结果:21例SFTs患者,男性11例、女性10例,平均年龄48.3岁,肿瘤大小3~30 cm,13例来源于胸膜,8例来自胸腔内其他特殊部位(包括1例气管源性、1例肺内来源)。17例患者接受手术完整切除肿瘤,2例接受姑息性切除,2例未手术。1例未手术者失访,其余20例患者随访1~96个月,其中1例未手术患者出院后死于心脏病,有3例分别于术后第12、26、72个月复发,接受了再次手术。7例术后或者穿刺活检证实为恶性。结论:胸部SFTs以胸膜源性为主,外科手术效果好,复发后再次切除仍可获得良好的效果。

Objective： To summarize the surgical treatment experience of thoracic solitary fibrous tumors （SFTs）, especially some special SFTs. Methods： Patients with SFTs in our department between January 2009 and May 2017 were recruited in this study and the clinical characteristics were summarized. Results： Twenty-one patients （11 men and 10 women） with an average age of 48.3 years were included. Tumor sizes ranged from 3 to 30 cm and 13 patients （61.9%） harbored pleural tumors, while 8 patients harbored tu- mors from other special thoracic sites （including 1 case of trachea SFT and 1 case of pulmonary SFT）. Surgical treatment was per- formed in 19 patients, 17 of whom underwent complete tumor resection and two patients underwent palliative resection. One patient did not undergo surgery and was lost to follow-up, and another patient who did not undergo surgery died because of a heart attack af- ter discharge. The 19 patients who underwent surgery were followed up for 1-96 months, 3 patients of whom underwent reoperation for tumor recurrence at 12, 26, and 72 months after surgery, respectively, while the remaining patients had no recurrence. Seven patients （33.3%） were confirmed with malignancy after operation or biopsy. Conclusions： Thoracic SFTs are mainly from the pleura and the surgical results are favorable. Resection after recurrence can achieve favorable results.