头颈部侵袭性纤维瘤病2例及文献复习

目的:探讨头颈部侵袭性纤维瘤病的临床表现、病理特征、治疗方式及预后,为临床医生正确诊治及降低该病复发率提供帮助。方法:回顾性分析2例头颈部侵袭性纤维瘤病的临床资料并复习相关文献。结果:侵袭性纤维瘤病以浸润性生长、局部易复发及无远处转移为特点。病理学表现为成纤维细胞单克隆增生,由分化良好的成纤维细胞和肌成纤维细胞组成,无恶性细胞学特征和有丝分裂相。本组患者中1例第1次手术后复发,再次手术后随访6个月无复发;另1例手术后随访6个月未复发。结论:头颈部侵袭性纤维瘤病症状无特异性,诊断主要依靠术后病理,彻底手术切除是治疗并减少复发的主要手段。对于复发或难以完整切除的患者,可配合放化疗。

Aggressive fibromatosis of the head and neck (A report of two cases and literature review)

Objective:To evaluate the clinic manifestation,pathologic behavior,therapy and prognosis of rare aggressive fibromatosis in the head and neck.Method:Two cases of aggressive fibromatosis were analyzed and relevant literatures were reviewed.Result:Aggressive fibromatosis was characterized as infiltrative,locally aggressive and tended to recur after surgical resection.Pathology showed fibroblastic monoclonal proliferation.Fibromatosis was composed of well-differentiated fibroblasts and myofibroblasts,lacking cytological features of malignancy and scanty or absent mitotic activity.Complete surgical excision of aggressive fibromatosis was considered to be the only effective method of cure by most authorities.Chemotherapy and radiotherapy can be used together with surgery in recurrence or unsatisfactory surgical margin.In our study,one patient recurred after the first operation,and after another operation,the patient did not recur after 6 months follow up,and the other one did not recur after 6 months follow up.Conclusion:The diagnosis of aggressive fibromatosis depended on pathological examination.Radical removal was an important way to reduce recurrence rate.Radiation therapy and chemotherapy can be used as adjuvant therapy in patients with recurrent or unresectable or inoperable disease.