复发性颌面部巨大隆突性皮肤纤维肉瘤的多次手术治疗  

Multiple reoperation of recurrent maxillofacial huge dermatofibrosarcoma protuberans

作　　者：林文彪[1] 张龙城[1] 全超坤[1] 

机构地区：[1]解放军第303医院耳鼻咽喉头颈外科,南宁530021

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第21期1894-1897,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：总结1例复发性颌面部巨大隆突性皮肤纤维肉瘤的多次手术治疗经验。方法：患者经病理确诊为隆突性皮肤纤维肉瘤,2004-2011年间多次采取扩大手术切除联合Mohs显微手术及游离皮片移植法治疗,术后密切随访。结果：多次手术均彻底切除肿瘤,创面植皮均成活,但术后反复复发,间隔时间7个月~5年8个月,复发间隔逐次延长,复发部位均为Mohs显微手术切缘。结论：对于颌面部巨大隆突性皮肤纤维肉瘤,早期扩大手术切除是治疗首选,晚期可联合Mohs显微手术,一期修复不主张使用肌皮瓣,可行植皮术,同时建议术后积极辅助放疗并密切随访观察,及早干预。Objective：To Summary the experience of surgical treatment for many times in 1 case of maxillofa cial huge dermatofibrosarcoma protuberans . Method：The patient was diagnosed with dermatofibrosarcoma protuberans according to the pathological examination. From 2004 to 2011, the patient underwent extensive surgical resection, Mohs micrographic surgery（MMS） and free flap grafting method as surgical treatment for many times, and was closely followed-up after operation . Result： The tumor was completely removed in each operation,with wound skin graft survived. But relapse occured repeatedly, recurrence interval was from 7 months up to five years and eight months, recurrence interval gradually extended, all of the recurrence occurred at Mohs microsurgery cut edge. Conclusion：Eexpanded resection is the preferred treatment for the early stage maxillofacial huge dermatofibrosarcoma protuberans. For advanced stage tumor, expanded resection should be combined with Mobs microsurgery. Free flap grafting was suggested in primary repair insteading of myoeutaneous flap , At the same time, postoperative assistant radiotherapy, strengthen follow up and early intervention were suggested.

关 键 词：隆突性皮肤纤维肉瘤 颌面部 外科手术 

分 类 号：R739.6[医药卫生—肿瘤]