A Clinical Study Of Aggressive Fibromatosis

Objective Aggressive fibromatosis is a rare fibroblast neoplasm with a special biological behavior. At present , because of our insufficient clinical cognition ,the managements of them are inappropriate ,which effects the prognosis of the patients with aggressive fibromatosis ,leads to poor life quality .Our study on this problem is to understand its biological behavior and evaluate the clinical feature and the treatment of aggressive fibromatosis.Methods From July 1997 to March 2005, a retrospective analysis was performed with 44 cases of aggressive fibromatosis in the Qilu Hospital of Shandong University, including the age ,as well as the gender,location of aggressive fibromatosis,preoperative auxiliary examinations,feature of pathologic,clinical manifestation to analysis the biological behavior and clinical behavior of aggressive fibromatosis. Then following up all the patients and making a statistic analysis to find out the relationship between the prognosis and the surgical mode.Results Among the 36 cases of aggressive fibromatosis,10cases are male,the other 26cases are female, the rate is 1:2.60. The average age of onset is 26.7 years(range:7～64 years). The median time before examination is 1.5 years(range:2 months～4 years). They typically present is a mass with pain(11 cases) or not(21 cases) or handicapped(4 cases). 36 cases make non-constrast CT scan for preoperative diagnosis and 28 cases are made diagnostic.20 cases make constrast CT scan and 18 cases are made diagnostic.32 cases make MRI for preoperative diagnosis and 30 cases are made diagnostic.Surgical excison is the mainstay treatement.32 patients have been followed up, the follow-up rates is 88.9%. The recurrence rates is 34.3%. By univariate analysis ,the different surgical type is a factor affecting the recurrence rates of aggressive fibromatosis.Conclusions Aggressive fibromatosis is a type of borderline tumor exhabiting local aggressiveness.High onset is in female and the age of high onset is between 10 and 40 years. They typically present is a mass with pain or not. MRI is more excellent than CT in delincating the site,shape and extent of these lesions.MRI is valuable in detecting and differentiating aggressive fibromatosis. The pathologic proves that aggressive fibromatosis is fibro-source ,and different from sarcoma. Pathologic is the final standard of diagnosising aggressive fibromatosis. Aggressive fibromatosis has high recurrence rate, and should be treated as a soft tissue tumor with low malignancy. Surgery is the optimal of therapy,and wide excision or radical excision is the best therapy. Radiotherapy and chemotherapy or endocrine therapy might be effect to aggressive fibromatosis.