ABSTRACT
INTRODUCTION: This work presents clinical evolution and functional outcome of patients with histologic diagnosis of Muscle-aponeurotic aggressive fibromatosis in 10 years of follow up in the National Rehabilitation Institute. MATERIAL AND METHODS: We performed a descriptive, retrospective, cross sectioned clinical trial in the Bone Tumour Department. We reviewed the clinical and radiological files from 1996 to 2006. INCLUSION CRITERIA: both genres, any age, clinical and histological diagnosis. EXCLUSION CRITERIA: incomplete file, lost to follow up, other diagnosis. Elimination criteria: Death during trial period. Analyzed variables. Age, genre, occupation, birth place, school degree, anatomic situation, signs and symptoms, time of follow up, treatment, relapses. We used statistical computed system Excel 2007, with central trend descriptive variables. RESULTS: Eleven patients (mean age 24.36; SD 18.32, 1-61 years), 9 female (81.8%) 2 male; birth place: Mexico City 7 (63.63%), Puebla 1, Toluca 1, South Baja California 1 and Chiapas 1. Anatomic situation: Pelvis 6 (54.54%), thoracic and gluteus 3. Pain and presence of a mass 10 (90.9%), range of motion limitation 5, edema and erithema 1. Relapses 6 (55%). TREATMENT: broad resection 3 patients, marginal resection 6 patients, radical resection 2 patients. CONCLUSIONS: If clinical suspicion of Muscle-aponeurotic fibromatosis appears, one should start protocol work up: laboratory, radiographic assessment, nuclear medicine, biopsy and histologic and immune-histochemistry. One should perform broad resections aiming to preserve the most possible extremity tissue disease free.
Subject(s)
Fibromatosis, Aggressive , Muscle Neoplasms , Adolescent , Adult , Child , Child, Preschool , Cross-Sectional Studies , Female , Fibromatosis, Aggressive/diagnosis , Fibromatosis, Aggressive/surgery , Humans , Infant , Male , Middle Aged , Muscle Neoplasms/diagnosis , Muscle Neoplasms/surgery , Retrospective Studies , Time FactorsABSTRACT
BACKGROUND: Intraoperative consultation is an integral part of surgical pathology. However, there are few reports concerning intraoperative pathology consultation exclusively for bone tumors. METHOD: Our hospital is an orthopedic institution that specializes in the diagnosis and treatment of bone tumors, and we retrospectively reviewed the intraoperative consultations for bone tumors on our service from January 2002 to February 2006. The objectives of this work were to: (1) evaluate the clinical reasons for intraoperative consultation on bone tumors; (2) identify discordant diagnoses between the intraoperative consultation diagnosis and the definitive diagnosis; (3) determine in how many cases it was possible to establish a specific diagnosis; and (4) analyze the accuracy of the intraoperative consultation diagnosis on the bone tumors. RESULTS: The two most common reasons for an intraoperative consultation were to rule out malignancy and to determine the adequacy of the resection margins. The third most common reason was to establish a diagnosis. In the latter cases, it was possible to establish a specific diagnosis in 86.3% of the cases; and we had only one discordant case. CONCLUSIONS: Intraoperative consultation on bone tumors has problems and limitations. They are due mainly to the characteristics of the material that comprise the specimen from this type of lesion. It is important that similar assays be carried out at medical institutions that specialized in bone tumors to determine the effectiveness rates of intraoperative consultation in this field throughout the world. This is the first series that has analyzed the accuracy of intraoperative consultation on bone tumors with respect to the clinical reasons for the consultation.
