Diagnosis and surgical treatment for complex solitary fibrous tumor in the mediastinum
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摘要: 目的 探讨复杂性纵膈孤立性纤维性肿瘤(solitary fibrous tumor,SFT)的临床特点、诊断及外科治疗方法,分析此类疾病的治疗预后情况。 方法 回顾性分析2014年5月—2015年6月蚌埠医学院第一附属医院收治的经术后病理和免疫组织化学分析确诊的3例复杂性纵膈SFT患者的临床资料,结合术后随访情况进行分析。3例患者临床表现:刺激性干咳为主1例,胸闷、气短1例,胸部不适感1例。术前均行胸部增强CT检查等常规检查,未见转移等其他手术禁忌症,术前充分准备,根据肿瘤所在的部位,选择不同的外科手术方法。手术方式:1例左后下纵膈肿瘤经左进胸行肿瘤切除术;1例左后下纵膈肿瘤经左进胸行肿瘤切除联合左下肺叶切除术;1例右后下纵膈肿瘤经右进胸行肿瘤切除术,并在外侵严重处用钛夹标记,术后4周行放射治疗。随访主要复查项目为术后1个月复查胸部X线片,术后3~6个月复查胸部CT,术后1~3年每年复查一次胸部CT。 结果 3例患者均手术顺利,肿瘤完整切除。其中1例患者术后出现胸闷症状加重,经对症处理后好转。3例患者均获得随访,随访期间均无复发及转移。 结论 复杂纵膈孤立性纤维性肿瘤是一种少见的纵膈肿瘤,诊断需经病理及免疫组织化学分析,首选外科手术治疗,完整切除预后良好,需严密随访,外侵严重术后需辅助放疗。Abstract: Objective To investigate the clinical features,diagnosis and surgical treatment of complex mediastinum solitary fibrous tumor(SFT),and analyze the conditions of treatment and prognosis of such diseases. Methods The clinical data of three complex mediastinum SFT patients confirmed by postoperative pathology and immunohistochemistry in our hospital between May 2014 and June 2015 were analyzed retrospectively.The follow-up materials were reviewed.The main clinical manifestation of these three patients included the irritating dry cough in one patients,chest tightness and shortness of breath in one patient,and chest discomfort in one case.The enhanced chest CT examination was performed in all patients before the operation.No metastasis and other surgical contraindications were found.The proper surgical method was selected according to the location of the tumor.The operation methods included:left posterior-inferior mediastinum tumor was cut via the left for tumor resection;left posterior-inferior mediastinum tumor via left for tumor resection and with left-lower lobectomy;inferior-right-posterior mediastinum tumor resection via right into the chest,mark the serious part with titanium clip,and postoperative four weeks for radiotherapy.The examinations in follow up included one month later review of chest X-ray,3 to 6 months after the operation for the chest CT,and 1 to 3 years after the operation for one time of chest CT yearly. Results All patients were operated successfully,and the tumor was resected completely.Among them,one patient had more serious chest tightness,which was improved after the symptomatic treatment.All of the 3 patients were followed up,and no recurrence and metastasis during the follow-up period. Conclusion Complex mediastinum SFT is a rare mediastinal tumor,diagnosis should be made by pathology and immunohistochemistry analysis,surgical treatment is the first choice,with complete resection and good prognosis,and close follow-up is required,for the severe postoperative invasion,neoadjuvant radiotherapy is required.
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Key words:
- Mediastinal tumors /
- Solitary fibrous tumor /
- Diagnosis /
- Surgical Treatment
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