Superficial and Deep Situated Fibromatoses: Similar Histomorphologic Appearance but Different Biological Behavior

Öz

Aim: Fibromatoses are a locally infiltrative soft tissue tumors being situated superficial or deep tissues and usually treated by surgical excision. The surgical local control of these tumors, especially ones arising from deep tissues, remains a significant problem. On this study, we aimed to investigate the clinical, histopathological and immune staining features of superficial and deep fibromatoses diagnosed our laboratory. Material and methods: Consecutive twelve cases diagnosed as fibromatoses between January 2005 to December 2013 were included to the study. Patients' ages, sex, the localization of tumor, the tumor size, histomorphological features and immune staining profiles of tumors were investigated. Statistical analyses were performed using Mann–Whitney U and Chi-Square/Fisher's Exact test. Results were considered to be significant at p < 0.05. Results: Four cases were superficial-seated, and 8 cases were deep-seated fibromatoses. The age of patients ranged from 18 to 72 (mean 62.5). All of superficial fibromatoses were male. All of deep fibromatoses were female. No recurrence was observed on superficial tumors. Three (37.5%) of deep-seated tumors had recurrent. The size of superficial tumors ranged from 1.5 cm to 4.5 cm (mean: 3.5 cm). The size of deep-seated tumors ranged from 1.5 cm to 15 cm (mean: 9 cm). There was no statistically significant difference between the two groups, in terms of the patients' age (p= 0.173), the recurrence rate (p= 0.491), Ki-67 proliferation index (p = 0.248) and immune staining for desmin (p= 0.491), smooth muscle actin (p= 0.091), S-100 protein (p= 0.515), Ki-67 (p = 0.236). Statistically, a significant correlation was observed between the two groups, in terms of the gender (p= 0.002) and the tumor size (p= 0.042). Conclusion: The histomorphological appearance and immune staining characteristics of superficial and deep-seated fibromatoses are similar. However, the clinical features and in terms of biological behavior of these two entities seems to be different from each other

Anahtar Kelimeler

• Soft tissue
• fibromatoses
• desmoid tumor

YÜZEYSEL VE DERİN YERLEŞİMLİ FİBROMATOZİSLER: BENZER HİSTOMORFOLOJİK GÖRÜNÜM ANCAK FARKLI BİYOLOJİK DAVRANIŞ

Öz

Amaç: Fibromatozisler yüzeysel ya da derin
yerleşimli olabilen ve çoğunlukla cerrahi eksizyon ile
tedavi edilen, lokal infiltratif yumuşak doku
tümörleridir. Özellikle derin yerleşimli
fibromatozislerin cerrahi ile lokal kontrolü sorun teşkil
etmektedir. Bu çalışmada laboratuarımızda
fibromatozis tanısı alan yüzeysel ve derin yerleşimli
olguların klinik, histopatolojik ve immün boyanma
özellikleri karşılaştırılmıştır.
Gereç ve yöntemler: Ocak 2005 ile Aralık 2013
tarihleri arasında fibromatozis tanısı alan 12 olgu
çalışmaya alındı. Hastalarda yaş, cinsiyet, tümör
yerleşimi, tümör boyutu, tümörlerin histomorfolojik
ve immün boyanma özellikleri karşılaştırıldı.
İstatistiksel analizlerde Mann–Whitney U ve Chi-
Square/Fisher's Exact testi kullanıldı. p < 0.05
sonuçlar anlamlı kabul edildi.
Bulgular: Fibromatozis tanısı alan olguların 4'ü
yüzeysel, 8'i derin yerleşimli idi. Hastaların yaşı 18 ile
72 arasında değişmekteydi (ortalama 62,5). Yüzeysel
yerleşimli olguların hepsi erkek, derin yerleşimli
olguların hepsi kadındı. Yüzeysel yerleşimli
tümörlerde nüks izlenmezken derin yerleşimli
olgulardan 3'ü (%37,5) nüksetmişti. Yüzeysel
yerleşimli tümörlerin boyutu 1,5 cm ile 4,5 cm
arasında değişmekteydi (ortalama 3,5 cm). Derin
yerleşimli tümörlerin boyutu 1,5 cm ile 15 cm
arasında değişmekteydi (ortalama 9 cm). İstatistiksel
analizde tümör lokalizasyonu ile cinsiyet (p= 0,002)
ve tümör boyutu (p= 0,042) arasında anlamlı ilişki
saptandı. Tümör yerleşim yeri ile yaş (p= 0,173), nüks
oranı (p= 0,491), desmin (p=0,491), düz kas aktin (p=
0,091), S-100 protein (p=0,515), Ki-67 (p= 0,236)
immün boyaları ve Ki-67 proliferasyon indeksi
(p=0,248) arasında anlamlı ilişki görülmedi.
Sonuç: Yüzeysel ve derin yerleşimli fibromatozislerin
histomorfolojik görünümü ve immün boyanma
özellikleri birbirine benzerdir. Ancak klinik özellikleri
ve biyolojik davranışları açısından bu iki antite
birbirinden farklı gibi gözükmektedir.

Anahtar Kelimeler

• Yumuşak doku
• fibromatozis
• desmoid tümör

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