"Original starting"
Hard fibroma is a strange tumor that does not move, but it is annoying because it is easy to relapse!
The literature read this week is about hard fibroma, which answers a lot of questions:
1. What kind of tumor is hard fibroma?
2. How is hard fibroma diagnosed?
3. Do I need to surgery for hard fiber tumors?
4. I don’t want to surgery, there are no other ways?
5. Does hard fibroma affect pregnancy?
Hard fibroma review literature
What kind of tumor is hard fibroma?
Hard fibroma (also known as invasive fibroma) is a rare tumor with a incidence of about five million, mostly at 30-40 years old.Tumor cells of hard fibroma are fibroblasts.It is a clone of fibroblasts to form tumors.This tumor generally grows in deep tissues and grows in infiltration. For example, it can grow to surrounding muscles like crab claws. Therefore, it is easier to relapse after surgical resection, but it will hardly transfer.
Influencia grows like a crab claw to the surrounding muscles (referred to as the arrow)
Will this tumor disappear if it is not treated?——This is really possible!According to statistics, 20%-30%of tumors will subscribe spontaneously!Hard fibroma in any part is likely to subscribe by itself. Among them, the hard fibroma with abdominal walls is most common.
Cases of hard fibroma self -decline
How is hard fibroma diagnosed?
All soft tissue tumors are recommended to be diagnosed and treated, and hard fibroma is no exception.Doctors will issue MRI examination forms, which helps to judge the location of the tumor.Pochological examination tissue to do pathological diagnosis is a key step in diagnosis and treatment of hard fibroma. Before any treatment, the diagnosis must be clear.It is not recommended to use a cut biopsy or resection biopsy to clear the diagnosis.In addition to observing the shape of tumor cells under a microscope, the pathology doctor may also perform some more targeted examinations, including the immunohistochemistry and gene sequencing of B-Catenin. These are more time-consuming.One of the reasons for the result.
Do I need to surgery for hard fiber tumors?
Before 2000, hard fibroma was removed according to the widespread resection of sarcoma, and its 5 -year non -recurring probability was 80%.Studies have found that tumor parts are the main factor affecting tumor recurrence: the recurrence rate of hard fibroma tumors in the abdominal wall is low, and the recurrence rate of hard fibroma tumors in trunk and limbs is higher.However, it is worth mentioning that the boundary of the surgical boundary is not necessarily directly related to the recurrence, that is, some border -positive tumors have not recurred!The results of these studies enabled experts to review the treatment of hard fibroma.Combined with the characteristics of hard fibroma that can be faded by themselves before, more and more experts generally do not recommend surgery immediately, especially when surgery will cause obvious functional loss, it is also recommended to observe first.If the tumor continues to increase during observation, consider surgical resection.Surgical resection should pursue R0 resection, that is, no tumor cells can be seen in the removal boundary, but also consider the retention of limb -related functions. If the removal boundary is not satisfactory and communicate with the patientYou can also review without radiotherapy (because even if you see tumor cells in the cutting edge under the microscope, less than 50%of the opportunity will recur, very interesting!)
The cutting edge situation is not directly related to whether it is recurrence
However, it is necessary to pay attention to the following special circumstances: if the abdominal rigid fibroma has caused obstruction, it is recommended to surgery immediately!
If not surgery, radiotherapy or drug treatment can be considered.
I don’t want to surgery, there are no other ways?
have!Treatment of radiotherapy and drug treatment can be considered.
Anticatin drugs are used or combined with non -sterite anti -inflammatory drugs: The effect is average, and it is not used as a conventional recommendation, but it can be considered for hard fibromaoma.
If anti -estrogen therapy is invalid and the tumor continues to increase, you can consider chemotherapy: first small dose scheme (used or combined with Changchun flower alkali), and then consider conventional dosesTo.Hard fibroma on the abdominal cavity or head and neck often requires fast control of tumors. In this case, it is necessary to choose a rotten drug with conventional doses. Generally, chemotherapy is generally chemotherapy.
There are also some oral drugs, such as Emantinib and Soraphini, can also control tumors, but the cost is high.
Does hard fibroma affect pregnancy?
Although hard fibroma may increase during pregnancy, most of the cases can be controlled, so pregnancy generally does not need to remove the adaptive signs of hard fibroma immediately.Hard fibroma does not affect pregnancy, nor does it increase the risk of childbirth.It is generally recommended to observe 1-2 years before pregnancy to determine the growth characteristics of hard fibroma.
Summarize:
After the diagnosis is clear, the close observation of the first time (1-2 years) is made to determine the growth of tumors (the growth of slow growth/the trend of self-decreament/rapid growth?).During this period, MRI needs to be checked every 2 to March.
If the tumor progresses rapidly, enter the next process: For the abdominal wall hard fibroma, he starts to use anti -estrogen drugs. If it is invalid, surgical resection or radiotherapy.For abdominal hard fibroma, such as surgery, surgery is preferred.For postcard or pelvic hard fibroma, drug treatment can be considered, and surgery or radiotherapy can be performed.For hard fibroma on limbs or chest walls, you need to communicate with the patient and communicate.If the tumor violates the main neuropathy, it is not the first to surgical resection, and the preferred drug therapy, radiotherapy or isolation limb perfusion.For key parts such as head and neck and chest, drug treatment is preferably.
References: Annals of onCology 28: 2399–2408, 2017; uptodate clinical consultant
