Sarcoma Fibroblástico Mixoinflamatório: Relato de Caso/Myxoinflammatory Fibroblastic Sarcoma: Case Report
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Abstract
RESUMO
Introdução: O Sarcoma Fibroblástico Mixoinflamatório (SFMI) é um tumor de partes moles de baixo grau, raro, que apresenta predileção equivalente em ambos os gêneros, sem sofrer influência de fatores genéticos ou ambientais. Apresenta sintomas inespecíficos, o que dificulta o diagnóstico. A dor está presente no diagnóstico em cerca de 17% dos pacientes. Outro fator que atrapalha o diagnóstico está na raridade do tumor e inabilidade técnica de detectá-lo. Casuística: Apresenta-se um caso de um paciente do sexo masculino, de 47 anos encaminhado ao ortopedista com tumoração em região distal do segundo quirodáctilo da mão direita. Após cirurgia de ressecção tumoral foi detectado um tecido que se originava na falange distal e tinha coloração amarelada e consistência densa, mesclado com o subcutâneo. Observou-se isquemia transitória na polpa digital da falange distal ainda durante a cirurgia. Posterior exame imuno-histoquímico revelou tratar-se de um Sarcoma Fibroblástico Mixoinflamatório. Após a cirurgia, o paciente retorna com necrose da polpa digital submetida a cirurgia. Foi realizada limpeza e debridamento do tecido necrótico. O paciente evoluiu bem com total epitelização da área cruenta. Conclusão: Foi concluído tratar-se de um sarcoma de difícil diagnóstico, porém de baixa metastatização e bom prognostico.
Palavras-chave: Sarcoma, Isquemia, Necrose.
ABSTRACT
Introduction: Myxoinflammatory Fibroblastic Sarcoma is a low-grade, rare tumor of soft parts that presents equivalent predilection for both genders suffering no influence of genetic or enviormental factors. It has non-specific symptoms, making it difficult to diagnose. Pain appears in the diagnosis only in 17% of patients. Another factor that hinders the diagnosis is in the fewness numbers of patients that have it, and the technical inability to detect it. Case Report: This case report describes the case of a male patient, 47 years old, that referred to the orthopedist a tumor in the distal region of the second finger of the right hand. After tumor resection it was detected a tissue that originated in the distal phalanx and had a yellowish color and dense consistency, mixed with the subcutaneous tissue. It was observed transient ischemia in the digital pulp of the distal phalanx during surgery. Subsequent immunohistochemical examination revealed that it was Myxoinflammatory Fibroblastic Sarcoma. After the surgery, the patient returned with necrosis of the fingertip. Cleaning and debridement of necrotic tissue was performed. The patient developed a complete epithelialization of the wound area. Conclusion: The conclusion is that this is a sarcoma which is difficult to diagnose, but with low metastasis and good prognosis.
Keywords: Sarcoma, Ischemia, Necrosis.
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