FIBROSARCOMA

From Big Medical Encyclopedia

FIBROSARCOMA (fibrosarcoma; lat. fibra fiber + sarcoma) — the malignant tumor developing from fibroblasts.

T. makes apprx. 12% of all sarcomas of soft tissues of a trunk and extremities. The tumor meets in any age group, but to a thicket is observed aged from 40 up to 70 years, can be inborn. More than in half of cases F. the hl is localized on the lower extremities. obr. on a hip, much less often it is located on upper extremities of N a trunk. At children F. is located in distal departments of extremities more often, it is preferential in anklebones and feet. Usually F. is deeply lying tumor, it is connected with fascial structures and muscles, often is located near large vessels and nerves, especially at localization on a hip.

Macroscopically it, as a rule, has the form of the dense roundish or lobular node which is accurately delimited from surrounding fabrics, grayish-white color on a section, more than 5 cm in the diameter. In the pseudo-capsule of a tumor signs of its invasive growth are found. T. it is formed by hl. obr. monomorphic spindle-shaped fibroblastopodobny cells with hyperchromic oval or oblong kernels and scanty eosinophilic cytoplasm. Cells are located in a fibrous basis, creating randomly intertwining bunches often forming the drawing of a fir-tree (tsvetn. tab., Art. 368, fig. 3). Always figures of mitoses, sometimes quite numerous are found (tsvetn. tab., Art. 368, fig. 4). Polymorphism of cells is not characteristic for F. also it is, as a rule, expressed poorly. Depending on a differentiation of a tumor D. J. Pritchard and soavt. (1974) allocated 4 degrees of a fibrosarcoma. According to these researchers, in 39,2% of cases more differentiated fibrosarcomas (I and II degree) and in 60,8% — less differentiated meet (III and IV degrees).

For F. emergence of a tumor is characteristic, edges pain increases in a size, and also. Approximately in 20% of cases developing of a tumor is preceded by an injury. Metastasises, hl. obr. hematogenous (first of all in lungs), are observed approximately in half of cases.

The treatment combined. Operational treatment consists in broad excision of a tumor, and at the expressed local distribution and a repeated recurrence amputation (see) or an exarticulation (see) extremities can be made. Are used preoperative and postoperative radiation therapy (see), apply various options of chemotherapy (see Chemotherapy of tumors).

According to D. J. Pritchard and soavt. (1974), recurrent tumors arise in 56,8% of cases on average in

18 months after operation and can be repeated; 5-year survival makes 41%, 10-year-old — 29%. Clear correlation between degree of a differentiation of a tumor and an indicator of survival is noted: 10-year-old surviving

the bridge at the I degree of a differentiation of a tumor made 80%, the II degrees — 37%, the III degrees — 27% and

the IV degrees — 0. At children F. proceeds more favorably. So, according to the Soul (E. N of Soule) and Pricharda (1977), at children under 5 years recurrent tumors are observed in 43%, and metastasises — in 7,3%.

See also Sarcoma.

Bibliography: Vikhert A. M., etc.

Tumorous formations and tumors of connecting fabric, page 105, M., 1977; Pathoanatomical diagnosis of tumors of the person, under the editorship of N. A. Krayevsky, etc., page 31, M., 1982; Chung E. Century of a. E n zinger F. M of Infantile fibrosarcoma, Cancer, v. 38, p. 729, 1976; M a-c k en z i e D. H. The differential diagnosis of fibroblastic disorders, p. 121, Oxford — Edinburgh, 1970;

Pri tchard D. J. a. o. Fibrosarcoma — an elinicopathologic and statistical study of 199 tumors of the soft tissue of the extremities and trunk, Cancer, v. 33, p. 888, 197 4; Soule E. H. a. P r i-tchard D. J. Fibrosarcoma in infants and children, ibid., v. 40, p. 171 1, 1977; Stout A. P. Fibrosarcoma, malignant tumor of fibroblasts, ibid., v. 1, p. 30, 1948. V. M. Blinov.

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