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KMID : 0613319960020020171
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Journal of the Korean Bone and Joint Tumor Soceity
1996 Volume.2 No. 2 p.171 ~ p.177
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Treatment of Aggressive Febromatosis -Analysis of Factors on Local Recurrence-
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Lee Sang-Hoon
Kim Han-Soo
Kang Sang-Ho
Lee Han-Koo
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Abstract
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Fibromatosis is a benign locally invasive fibropriligerative tumor with a tendency to infilatrate widely between muscle fibers and along fascial planes and neurovascular bundles. It dose not metastasize but has a high tendency to local recurrence even after apparently complete resection. We reviewed 22 patients treated in Seoul National University Hospital between 1982 and 1995 for aggressive fibromatosis and analyzed the data of the clinical features, radiologic and pathologic findings and treatment methods to find out any factors influencing recurrence of the tumors. Seventeen patients were eferred from other hospital for management of recurrent disease and five patients were managed principally in our hospital. The midian follow-up period after the last surgery is 19 months(6-70). All of the 22 patients were treated with surgical excision and postoperative adjuvant external radiotherapy was done in four patients, one after the first operation in our hospital, the other three after operation for recurrence. There were 50%(11/22) of the cases with neurovascular involvements. Surgery alone was effective in 8 of 21 patients in local control after a median follow-up 16 months. Recurrence rate after surgery alone was 61.9%(13/21). Local control was obtained in 4 of 4 patients who received postoperative external adjuvant radiotherapy due to recurrence and neurovascular involvement over median follow-up of 29 (6-56)months. The size of tumor is greater than 10cm in the largest dimension in 11 cases, whose recurrence rate was 81.8%(9/11), higher than that of the other 11 cases, 45.5%(5/11), whose size of tumor is less than 10cm. On the contrary, the recurrece rate was 57.1%(4/7) after surgery in the cases with neurovascular involvement, and 54.5%(6/11) in the cases without neurovascular involvement (the 4 cases with neurovascular involvement were excluded due to postoperative adjuvant radiotherapy).
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KEYWORD
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Fibromatosis, Treatment, Recurrence
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