RESUMEN
The use of preoperative radiation is well-established for soft tissue sarcoma, but its use in fibromatosis is not well-characterized. The purpose of this study was to examine the impact of preoperative radiotherapy on the local control of fibromatosis and to assess treatment-related morbidity in this setting. In particular we assessed complication rates in comparison with soft tissue sarcoma treatment. All patients with fibromatosis referred to this unit who received preoperative radiotherapy (50 Gy in 25 fractions) from 1988 to 2000 and who had at least 2 years of followup were included in this study. The rate of recurrence in this group was ascertained. Similarly constructed datasets from all patients with soft tissue sarcomas of the extremities who received preoperative radiation from 1986 to 1997 also were analyzed. The rates of complications in the two groups were compared. Fifty-eight patients were treated with preoperative radiation for fibromatosis and the median followup was 69 months. There were 11 local recurrences (19%). Major wound complications manifested in two patients (3.4%). Wound-related complications arose in 89 of 265 patients with soft tissue sarcomas (33.5%). There was a significant difference in the rate of major wound complications observed in the two groups. The use of radiotherapy before surgery is effective in the combined treatment of fibromatosis.
Asunto(s)
Fibroma/radioterapia , Cuidados Preoperatorios/métodos , Radioterapia Adyuvante , Neoplasias de los Tejidos Blandos/radioterapia , Adolescente , Adulto , Anciano , Análisis de Varianza , Supervivencia sin Enfermedad , Femenino , Fibroma/diagnóstico , Fibroma/mortalidad , Fibroma/cirugía , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/etiología , Dosificación Radioterapéutica , Radioterapia Adyuvante/efectos adversos , Radioterapia Adyuvante/métodos , Factores de Riesgo , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/mortalidad , Neoplasias de los Tejidos Blandos/cirugía , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/etiología , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVES: Sarcoidosis affects the spinal cord in only 0.43% of patients with sarcoidosis. Usually there is systemic involvement prior to the development of cord lesions. We present a case of sarcoid isolated to the intramedullary spinal cord, which was a diagnostic and therapeutic challenge. We review the case and then present a review of the literature with an emphasis on presentation, diagnosis and treatment. METHODS: We have reviewed a patient who presented with an isolated sarcoid granuloma affecting the cervical spinal cord. All pertinent history and physical information was extracted from the patient's chart and through patient interview. Laboratory, radiographic and pathological investigations are presented. RESULTS AND CONCLUSIONS: Fourteen patients have been reported with isolated intramedullary spinal cord sarcoidosis. Current practice supports the role of surgery for biopsy; mainstay of treatment is corticosteroids.