纤维肉瘤的诊断与治疗(附13例报告并文献复习)

目的∶探讨纤维肉瘤的诊断与治疗。方法：分析我院１９９４年～１９９７年收治的纤维肉瘤病人１３例并复习有关文献。结果：院外行局部切除６例次（首次４例，复发后２例），均在术后１３天～１年复发，平均６７月，有１例复发５次；在我院首次广泛切除９例，除１例失访外，８例术后３年～１０年复发，平均６年；复发后再次行广泛切除术１２例１７例次，于术后７月～４年复发，平均２２年；复发后行广泛切除术加放疗３例，于３年～５年复发，平均４１年；１３例无远处转移，１例左大腿纤维肉瘤腹股沟淋巴结转移；误诊４例，误诊率高达３０％。结论：广泛性切除术是减少纤维肉瘤复法的重要方法；辅助放疗可能延长病人复发的时间；纤维肉瘤的诊断无特殊方法，术后病检仍是目前确认的主要手段。

The Diagnosis and Treatment of Fibrosarcomas (Report of 13 Cases and Review of Literatures)

Objective:To investigate the diagnosis and treatment of fibrosarcomas.Method: The clinical records of 13 cases with fibrosarcomas who underwent surgery in our hospital between 1994 and 1997 were analyzed and previous literature were reviewed.Result: Recurrence was noted in 6 cases with a range of 13 days to l year(average 67months),among them 4 cases with primary fibrosarcoma and 2 cases with recurrent fibrosarcoma were treated by locoal excision in other hospital,and nine cases underwent initial radical surgery in our hospital.Eight cases recurred in between 3 to 10 years(average 6 years),and 1case had lost contact.Twelve cases with recurrence were treated by radical excision for 17 times,recurrence ranged from 7 months to 4 years(average 22 years). Three cases treated again after recurrence by radAuthor ical surgery with adjuvant radiotherapy out recurred in between 3 to 5 years(average 41years).There were no distant metastasis in 13 cases.Out in 1case the left thigh fibrosarcomas showed metastasis of inguinal lymph node.Four cases were misdiagnosis.The rate of the error in diagnosis was 30%.Conclusion:Radical excision was an important treatment for reducing the rate of recrrence;adjuvant rediotherapy after surgery could delay the recurrence.Up to now no specific method could diagnose fibrosarcomas and pathology after surgery is still the main method in making accurate diagnosis.