Spinal fibromatosis: a report of two cases and review of the literature

Takagi, Ippei; Jacobsohn, Jamie A.; Golden, Barbara; Karahalios, Dean G.

doi:10.1016/j.spinee.2013.02.014

Cited by 7 publications

(18 citation statements)

References 28 publications

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“…(Table I) (1, 4-11, 13, 17-19). Sex hormones were claimed to affect fibromatosis, since both cases with abdominal wall fibromatosis and spinal fibromatosis are more common in females (6,17). However, our patient was in postmenopausal period.…”

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

confidence: 68%

“…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: 68%

Section: Introductionmentioning

confidence: 99%

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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“…They have a high incidence of recurrence after surgical resection, with head and neck DTs exhibiting among the highest rate of recurrence and are thus difficult to definitively cure. We have providgrowing, locally invasive, and recur after surgical resection at high rates [2][3][4]. While DTs at all sites commonly recur after surgical excision, recurrence rates with head and neck DTs are much higher.…”

Section: Resultsmentioning

confidence: 99%

“…While DTs do not spread metastatically, they can invade local tissue and frequently recur after surgical resection [2][3][4]; for this reason they are often categorized with low-grade soft tissue sarcomas [5]. Approximately 2-4 cases of DTs per million people occur each year, and account for 0.03% of all neoplasms [6] and 3% of soft tissue tumors [7].…”

Section: Introductionmentioning

confidence: 99%

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Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Eichberg¹,

Urakov²,

Vanni³

2017

Clin Med Rev Case Rep

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Objective: To provide an overview of head, neck, and spine Desmoid Tumor (DT), to describe the case of a patient who underwent aggressive surgical resection of a large invasive cervical DT, and to analyze the DT literature. We discuss the importance of aggressive surgical margins in decreasing recurrence risk in head, neck, and spine DTs. Methods:A twenty-three-year-old female patient with history of a left cervical neurofibroma resection presented two years later with neck mass regrowth. The mass was aggressively resected, and occiput to T1 fusion was performed. Additionally, the head, neck, and spine DT literature was reviewed regarding surgical margin status and recurrence rate. A "N-1" Chi-squared test was used to compare proportions, between percentage of patients that experienced recurrence after gross total resection, and percentage of patients that experienced recurrence after subtotal resection, to determine statistical significance (p < 0.05).Results: Histologically, the lesion was shown to be a DT, with posterior paracervical spinal musculature invasion. The surgery was well tolerated with no complications. At eight years postoperative followup, the patient is doing well with no tumor recurrence. Nine studies were identified describing surgical margin status and recurrence rate of head, neck, and spine DT. When recurrence rates were compared in patients with grossly negative surgical margins and grossly positive surgical margins for head, neck, and spine DTs, two studies showed statistical significance (p < 0.05) for lower recurrence rate after gross total resection, and seven showed a trend toward lower recurrence rates in patients with gross total resection. Conclusion:DTs are difficult clinical entities to cure due to high recurrence rate after resection. Consistent with previous studies indicating that aggressive surgical margins are associated with a decreased risk of recurrence, we present a case report of a female patient who underwent aggressive resection of a large DT and remains tumor-free after eight years. Thus, we recommend aggressive surgical resection of head, neck, and spine DTs to minimize recurrence risk.

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Paraspinal desmoid fibromatosis after lumbar epidural analgesia

Remedios

Sommerfield

Fellingham

et al. 2021

Anaesthesia Reports

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A 14-year-old girl with cerebral palsy presented for bilateral lower limb surgery for spasticity. A lumbar epidural catheter was sited under general anaesthesia on the third attempt and used intra-operatively with good effect. A local anaesthetic infusion was used for postoperative analgesia but was noted to be leaking under the dressing with a patchy, unilateral block. The catheter was therefore removed on the second postoperative day. Following discharge, the patient progressively developed new back and leg pain for which she was re-admitted seven weeks later. This was investigated and initially thought to be myositis of the erector spinae muscles on magnetic resonance imaging. When the patient failed to respond to treatment, a muscle biopsy demonstrated desmoid fibromatosis. Trauma may cause or accelerate the development of desmoid fibromatosis, which has also been theorised to arise from scar tissue in previously injured areas. We hypothesise that challenging epidural placement or the leakage of the local anaesthetic agent into the surrounding muscular tissue, inducing local myonecrosis, could have been the triggering or accelerating event in tumour development. This may be the first reported case of extra-abdominal desmoid fibromatosis in association with epidural placement.

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Spinal fibromatosis: a report of two cases and review of the literature

Cited by 7 publications

References 28 publications

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

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

Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Paraspinal desmoid fibromatosis after lumbar epidural analgesia

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