Giant pendulous fibroma with unusual clinical appearance arising on the scrotum
Giant pendulous fibroma with unusual clinical appearance arising on the scrotum
复制标题
阴囊上出现临床表现异常的巨大下垂纤维瘤
DOI：
10.1111/j.1365-2230.1994.tb01188.x
复制
发表时间：
1994
影响因子：
4.1
通讯作者：
S. Imamura
中科院分区：
文献类型：
--
作者：
T. Kitajima;T. Okuwa;S. Imamura
有蒂纤维瘤通常小于3-5毫米，然而，在特殊情况下，它们可以达到儿童头部的大小。“发生在会阴部的纤维瘤最有可能达到极大的尺寸。在这份报告中，我们提出了一个巨大的下垂纤维瘤，其临床表现不寻常，发生在阴囊。一名20岁的男子提出了一个肿瘤的阴囊。我啊！大约3年前，患者在该部位发现了一个无症状的结节。渐渐地，它变大了，变得有蒂，表面变得像热的。他的阴囊没有外伤史。他来我院就诊是因为肿瘤生长迅速，偶尔会出现糜烂。在体格检查中，肿瘤大小约为6 x 8 x 5 cm，下垂，悬挂在阴囊中心的茎上。肿瘤表面呈灰色，由多个紧密排列的坚硬弹性结节组成，直径约为几mm至4 em（图1）。一般实验室检查结果在正常范围内。肿瘤，包括茎，被切除，并进行一期缝合。自那时以来没有复发。在横截面上，肿瘤呈实性。大部分部分是玻璃黄色的颜色，但茎是白色的。表皮出现中度棘皮症。真皮上层胶原纤维丰富，排列疏松，毛细血管扩张。在真皮下层，毛细血管更加扩张，间质空间水肿;在这些区域，胶原纤维分布更稀疏（图2）。阿累安蓝染色显示在较低的水肿基质中，特别是血管周围区域，以及许多成粘细胞中有蓝色线状物质（图3）。瘤柄中增厚的胶原束数量增加，血管明显扩张（图4），肿瘤中无非典型细胞。这个有蒂肿瘤的主要组织病理学表现是丰富的胶原纤维和大量扩张的毛细血管，这是软纤维瘤的特征。间质中广泛分布的粘液沉积物被认为是继发性的，有蒂纤维瘤有时会变得很大，患者往往因害羞而推迟就诊。会阴部血管丰富，肿瘤和蒂的下垂性质可导致循环功能不全或停滞;
SIR, Pedunculated fihromas are usually smaller than 3-5 mm. However, in exceptional cases, they can reach the size of a child's head,' The tendency to extreme size is greatest in fibromas occurring in the perineum,^ In this report, we present a case of giant pendulous fibroma with an unusual clinical appearance oceurring on the scrotum. A 20-year-old man presented with a tumour on the scrotum. I !e had noted an asymptomatic nodule at this site ahout 3 years before. Gradually, it had enlarged and become pedunculated, and the surface had become hotryoid. He had no history of trauma to the scrotum. He visited our hospital because of the rapid growth and occasional hieeding from erosions. On physical examination, the tumour was approximately 6 x 8 x 5 cm in size and pendulous, hanging from a stalk in the centre ofthe scrotum. The tumour had a grey-coloured surface and consisted of multiple closely set firm elastie nodules measuring approximately a few mm to 4 em in diameter (Fig, 1), The results of general laboratory investigations were within normal limits. The tumour, including the stalk, was resected and primary closure was carried out. There has been no recurrence since then. In cross-section, the tumour appeared solid. Most parts were a glassy yellow in colour, but the stalk was whitish. The epidermis showed moderate acanthosis. The upper dermis was composed of abundant loosely arranged collagen fihres and dilated capillaries. In the lower dermis, capillaries were more dilated and the interstitial spaces were oedematous; in these, collagen fibres were more sparsely distributed (Fig. 2). Aleian blue stain revealed blue thread-like material in the lower, oedematous, matrices, especially the perivaseiilar areas, and many mucoblasts (Fig. 3). Thickened collagen bundles were increased in number in the stalk, and vessels were grossly dilated (Fig, 4), There were no atypical cells in the tumour. The primary histopathologieal findings of this pedunculated tumour are the abundant collagen fihres and numerous dilated capillaries, features of a soft fihroma. The widely distributed muein deposits in the interstitial spaces are considered to he secondary, Peduneulated fibromas are known to become very large on occasion;' patients tend to delay presentation because of shyness. The perineum is rich in hlood vessels, and the pendulous nature of the tumour and the stalk may lead to circulatory insufficiency or stasis;