以维持美观为目的的外阴硬纤维瘤多学科外科管理

　　A multidisciplinary approach to surgical management of vuval desmoid tumour to maintain the cosmetic appearance 

　　S. Davies, K. Gajjar 

　　Womens Health, Lancashire Teaching Hospitals, Preston, UK 

　　Background: Desmoid tumours are rare benign neoplasms originating from musculo-aponeurotic structures throughout the body. There are a number of reported cases of vulval desmoid tumours. Although benign in characteristic they can cause local infiltration resulting in significant deformity, morbidity or even mortality from pressure effects of the tumour. Surgical resection is challenging and management frequently involves a multidisciplinary approach combining the expertise of several surgical specialists. Radiation therapy has been used as a primary therapeutic option since desmoids are radio-sensitive. It is particularly useful in those patients who have underlying morbidities and are not suitable for surgery.

　　Case report: We report a vulval desmoid tumour presenting as a painful vulval mass. After histological diagnosis the tumour was resected via a lateral vaginal wall approach with multi surgical specialty input to obtain resection with adequate margins and good cosmetic appearance.

　　Conclusion: A number of surgical approaches have been described in literature for the resection of vulval desmoid tumour. We believe that the surgical apprtoach adopted in this case allows for better cosmetic appearance and reduced postoperative recovery time. We identified intra-operative haemorrhage as a significant risk of surgical resection as previously highlighted in literature. 

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