Aggressive fibromatosis a rare cause for lumbar bulging

Oberthaler, W.; Rhomberg, Walter

doi:10.1007/bf00381069

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…It was shown to be related with a syndrome only in one case (1). Thoracic spine is the most common site of origin for spinal fibromatosis cases (4,7,8,10,13,17,18). Our patient had fibromatosis in lumbar spine region, which has been the third presentation of this region with fibromatosis, in the literature (5,11).…”

Section: Figure 2: Preoperative Contrast Enhanced T1-weighted Axial Imentioning

confidence: 59%

“…Our patient has been the oldest person with spinal fibromatosis, in the literature. Presenting symptoms are pain with or without mass, paresthesia and limb paralysis (4,(6)(7)(8)(9)(10)(11)13,(17)(18)(19). On the other hand, spinal fibromatosis can be totally asymptomatic (1).…”

Section: Figure 2: Preoperative Contrast Enhanced T1-weighted Axial Imentioning

confidence: 99%

“…Since spinal presentation of the fibromatosis is very rare; case reports are the only source of clinical knowledge. Hitherto, 14 cases have been described in the English literature (Table I) (1,(4)(5)(6)(7)(8)(9)(10)(11)13,(17)(18)(19). Now, we add an aggressive spinal fibromatosis case of the oldest aged patient in the literature, with 2 years follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Locally aggressive de novo spinal fibromatosis: case report and review of the literature

Ekşi

Türköz²,

Eksi³

et al. 2014

Turkish Neurosurgery

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Fibromatosis is a benign lesion, which originates from proliferating fibroblasts. Although fibromatosis is a benign tumor, it is locally aggressive and invasive. Spinal presentation of fibromatosis is very rare, and case reports are the only source of the clinical knowledge. Herein, we describe the oldest patient having spinal fibromatosis with de novo occurrence and aggressive nature. A 68-year-old female patient admitted to our outpatient clinic with low back pain and neurological claudication. On lumbar spine magnetic resonance imaging, she had spinal canal stenosis with a concomitant lesion in the left longissimus muscle. We did our best to resect the tumor, entirely. The pathology result was consistent with spindle cell lesion. The lesion recurred 6 months after the primary surgery. In the second surgery, we did en bloc resection. Pathology and immunohistochemical analysis results were consistent with fibromatosis. After the second surgery, she had adjuvant radiotherapy. There was nothing other than radionecrosis in the operation site, still after 2 years. In conclusion, radiological work-up is usually insufficient to make fibromatosis diagnosis and whole pathological specimen should be carefully evaluated to achieve the accurate diagnosis. Spinal fibromatosis is very rare and its treatment methods have not universally been conceptualized. However, adjuvant therapies are necessary after en bloc resection.KeywOrds: Fibromatosis, Lumbar spine, Radiotherapy, Surgery ÖZ Fibromatozis, fibroblastların çoğalması sonrası oluşan bening bir lezyondur. Fibromatozis, bening olmasına rağmen, lokal olarak agresifdir ve invazif bir seyir seyreder. Spinal fibromatozis çok nadirdir ve literatürde sadece olgu sunumları bulunmaktadır. Yazıda, de novo oluşan ve agresif bir klinik tabloya sahip olan, literatürdeki en yaşlı hasta sunuldu. Altmış sekiz yaşında kadın bir hasta kliniğimize bel ağrısı ve nörojenik kladikasyon ile başvurdu. Lomber MR incelemesinde, spinal dar kanal ile beraber, sol paraspinal alanda, longissimus kasının içinde kitle lezyonu saptandı. Mümkün olan en geniş cerrahi eksizyon uygulandı. Patoloji sonucu iğsi hücreli lezyon olarak geldi. Altı ay sonra, lezyon nüksetti. İkinci ameliyatta, en blok rezeksiyon yapıldı. Patoloji ve immünohistokimyasal çalışmalar patolojiyi fibromatozis olarak sonuçlandırdı. İkinci ameliyattan sonra hasta adjuvan radyoterapi aldı. Hastanın 2 yıllık takibinde radyonekroz dışında ek patoloji saptanmadı. Radyolojik çalışmalar fibromatozis tanısı konulmasında yetersiz olabiliyor; bu sebeple patolojik preparat detaylı olarak incelenmelidir. Spinal fibromatozis çok nadirdir ve hâlâ genel kabul görmüş standart bir tedavisi yoktur. Ancak; en blok cerrahiden sonra adjuvan tedaviler gerekmektedir.

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Section: Figure 2: Preoperative Contrast Enhanced T1-weighted Axial Imentioning

confidence: 59%

Section: Figure 2: Preoperative Contrast Enhanced T1-weighted Axial Imentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Locally aggressive de novo spinal fibromatosis: case report and review of the literature

Ekşi

Türköz²,

Eksi³

et al. 2014

Turkish Neurosurgery

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“…Only 25 known cases of paraspinal desmoid tumors have been reported, among which only 6 were in pediatric patients (►Table 1). [10][11][12][13][14]16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Desmoid tumors typically occur in the abdomen or extremities with surgery often being an antecedent. 2,4 The tumor's slow growing, benign course in our case is typical of desmoid tumor.…”

Section: Discussionmentioning

confidence: 99%

Paraspinal Desmoid Tumor in a Pediatric Patient with No Surgical History: A Case Report

Patel,

Varga,

Mallela

et al. 2024

Asian J Neurosurg

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Desmoid tumors are locally aggressive, benign neoplasms originating in connective tissues. Although the exact pathophysiology remains unknown, antecedent trauma or surgery are believed to be important contributing factors. The occurrence of paraspinal desmoid tumor in pediatric patients is extremely uncommon. Here, we present an exceedingly rare case of a pediatric patient with no surgical or family history who developed a paraspinal desmoid tumor.A 9-year-old female patient presented with 4 months of progressive back pain, right lower extremity weakness, and numbness. Spinal imaging revealed a left epidural paraspinal mass compressing her thoracic spinal cord and extending into the left thoracic cavity. A multidisciplinary approach with neurosurgery and thoracic surgery enabled gross total resection of the lesion. The patient had complete resolution of her symptoms with no signs of residual tumor on postoperative imaging. Pathology revealed a desmoid tumor that avidly stained for beta-catenin. On her last follow-up, she developed a recurrence, to which she was started on sorafenib therapy.Desmoid tumors are rare connective tissue neoplasms that often occur after local tissue trauma, such as that caused by surgery. This report presents a rare case of a pediatric paraspinal desmoid tumor that occurred in a patient with no surgical or family history. Such tumors should undergo surgical resection for symptomatic relief and tissue diagnosis. Close clinical and radiographic surveillance are essential in these patients due to the high recurrence rates of desmoid tumor.

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“…According to the World Health Organization classification, the term fibromatous tumor should be limited to those proliferations comprising fibers and cells stemming from fibroblasts17). Desmoid tumors grow locally and are invasive; thus, they are destructive but do not show metastasis, and are therefore often classified as semi-malignant17). Desmoid tumors have an annual incidence of 2-4 cases per million population4,10,13,15).…”

Section: Discussionmentioning

confidence: 99%