直肠及肛周炎性肌纤维母细胞瘤三例

目的 探讨直肠及肛周炎性肌纤维母细胞瘤的临床特点及其疗效.方法 回顾性分析2005年1月至2011年6月术后病理证实为直肠或肛周炎性肌纤维母细胞瘤3例患者的临床资料.结果 炎性肌纤维母细胞瘤局部表现为浸润性生长,MRI或CT常表现为富血管实性肿块,影像学难以同直肠癌或肉瘤、血管瘤鉴别,术前肠镜活检或局部针吸活检常难以明确肿瘤性质,需手术切除后整体送检,并行免疫组化确诊.3例患者均行保肛手术,1例患者术后16个月出现复发,再次行根治性手术,随访至今.3例患者已分别存活67、55和35个月.结论 直肠及肛周炎性肌纤维母细胞瘤术前不易确诊,病理诊断主要依赖免疫组化.局部完整切除可以在保留肛门的同时获得肿瘤的根治,局部复发也常有再次手术机会.

Rectal and perianal inflammatory myofibroblastic tumor: report of 3 cases

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.