目的:建立兔VX2软组织肿瘤模型，研究其高频超声表现。方法:2006年2～6月在12只大白兔后肢建立软组织肿瘤模型，行高频超声检查。结果:12只大白兔成功建立软组织肿瘤模型，超声表现为等回声为主，肿瘤边缘区域血供较中央区域丰富。结论:兔软组织肿瘤模型易于建立，超声有一定的特征性表现。
Objective To evaluate the effectiveness of soft tissue reconstruction after resection of musculoskeletal tumor and to discuss the strategy of soft tissue reconstruction. Methods Between June 2003 and December 2010, 90 patients with musculoskeletal tumor underwent tumor resection and soft tissue reconstruction. There were 59 males and 31 females with a median age of 37.2 years (range, 9-85 years), including 52 bone tumors and 38 soft tissue tumors. One stage reconstruction of soft tissue was performed after tumor resection in 75 cases; reconstruction of soft tissue was performed after debridement in 7 cases of wound dehiscence; and two stage reconstruction of soft tissue was performed after debridement and vacuum sealing drainage placement in 8 cases of infected wounds. The gastrocnemiums flap was used in 40 cases, the latissimus dorsi myocutaneous flap in 6 cases, rectus abdominis myocutaneous flap in 4 cases, gluteus maximus musculocutaneous flap in 1 case, pectoralis major muscle flap in 1 case, cross-abdominal flap in 1 case, local transfer flap in 27 cases, pedicled flaps in 5 cases, and skin grafts in 5 cases. The size of the flap ranged from 6.5 cm × 4.5 cm to 21.0 cm × 9.0 cm. Results Eighty-seven flaps survived, and incisions healed by first intention in 81 cases. In 6 cases of healing by second intention, 2 had partial flap necrosis, which was cured by dressing change; 3 had delayed healing; 1 had mild infection, which was cured after conservative treatment. Wound of donor site healed primarily, and the grafted skin survived. Seventy-three patients were followed up 10-102 months (mean, 36.1 months). Local tumor recurrence was observed in 6 patients, who received second resection at 2-27 months (mean, 8.2 months) after operation. Thirteen patients dead of primary disease at 6-34 months (mean, 19.2 months) after operation. Conclusion The defects caused by resection of musculoskeletal tumor require soft tissue reconstructions. Optimal reconstruction can enhance wound closure, decrease incidence of wound complication, preserve limb function.
Objective To investigate the method, effectiveness, andclinical application of the anterolateral thigh perforator free flaps for reconstruction of the soft tissue defects in the head and the four limbs after tumorresection. Methods From April 2004 to April 2006, 16 patients (13 males, 3 females; aged 26-72 years) with the soft tissue defects in the head (9 patients) and the four limbs (7 patients) underwent reconstructive operations with the anterolateral thigh perforator free flaps after their tumor resection. The defects ranged in area from 8 cm×6 cm to 20 cm×13 cm in the head with the process of diseases from 6 to 24 months, and the defects ranged in area from 10 cm×7 cm to 21 cm× 12 cm in the four limbs with the process of diseases from 2 to 18 months.The technique for the anterolateral thigh perforator flap freegrafting, the degree of the injury in the donor sites, and the appearance of the donor and recipient sites, and the influence on the anatomy and function in the both local sites were analyzed. Results In the 16 patients with the soft tissue defects in the head and the four limbs after tumor resection, 14 had a primary wound healing (Stage Ⅰ), and 2 had a delayed wound healing (Stage Ⅱ) . Fifteen flaps survived completely but two flaps had a partial failure. Theflap appearance was good and smooth without any severe scarring, and there was a minimal effect on the function at the donor and recipient sites. Conclusion Because of the less morbidity at the donor site, the better result at the recipient site, and the use of the anterolateral thigh perforator flap free grafting, this kind of the technique for reconstruction of the head and fourlimb soft tissue defects after tumor resection is well acceptable.
目的 探讨硬化性上皮样纤维肉瘤（SEF）的临床病理学特征。 方法 对2012年3月收治的l例SEF患者进行组织学观察、免疫组织化学检查并复习相关文献。 结果 SEF主要以细胞质透亮的上皮样肿瘤细胞伴大量透明变性胶原纤维为特征，瘤细胞排列主要呈条索状、巢状。肿瘤细胞波形蛋白阳性表达，细胞角蛋白和平滑肌肌动蛋白阴性表达。 结论 SEF是一种较为罕见的软组织肿瘤，应注意与一些具有上皮样形态和硬化性间质的肿瘤相鉴别。
ObjectiveTo analyze the characteristics of ultrasound images for soft tissue lymphoma and discuss the diagnostic value of ultrasonography. MethodsBetween January 2008 and August 2014, the ultrasound images of 25 soft tissue lymphomas confirmed by histopathology and immunohistochemistry were retrospectively analyzed. ResultsOf the total 25 patients with soft tissue lymphoma (histological types of non-Hodgkin's lymphoma), there were 10 females and 15 males. Among them, 14 had diffuse large B-cell lymphoma (56%, 14/25). There was a primary lymphoma located in the lower leg, and all the rest 24 cases were secondary lymphoma. Of the 24 secondary cases, 19 presented solitary lesion located respectively in limbs (8 cases), trunk (7 cases) and head & neck (4 cases); the other 5 cases presented multiple lesions located respectively in limbs and trunk. Among all the lesions, 12 were located in muscular layer, presenting weak echo mass with irregular shape growing along the direction of muscular fibers; and 13 were located in skin and subcutaneous soft tissue, among which 4 cases showed diffused thickening of skin and subcutaneous layer with irregular hypoechoic areas on ultrasound examination, and 9 cases showed nodular or hypoechoic irregular shaped lesion, iso-hyperechoic, with heterogeneous internal echogenecity having unclear boundary. ConclusionUnderstanding the characteristics of soft tissue lymphoma on ultrasound images will help to improve diagnostic accuracy.
ObjectiveTo evaluate the role of cardiopulmonary bypass (CPB) technique in the treatment of the abdominal soft tissue tumor (ASTT). MethodClinical data of 9 patients with ASTT who underwent CPB-aided resection in zhongshan Hospital of Fudan University from April 2011 to December 2015 were analyzed retrospectively. ResultsAll patients were performed complete resection of tumor, without perioperative death. Six patients received complete CPB technique and other 3 patients received partial CPB technique. In establishment of CPB, patterns of arterial perfusion included the ascending aorta (n=6) and femoral artery (n=3); patterns of venous drainage included the inferior vena cava (n=2), superior vena cava (n=6), femoral vein (n=2), and jugular vein (n=3). Among of them, 7 patients were diagnosed as intravenous leiomyomatosis, 1 patient was diagnosed as small round cell malignant tumor, and another 1 patient was diagnosed as leiomyosarcoma. Two patients occurred postoperative complications, 1 patient was duodenal fistula, with conservative treatment to heal; another 1 patient was inferior vena cava thrombosis, with treatment of placement of the inferior vena cava filter. Nine patients received follow-up, and follow-up time was 1-57 months (the median time was 4-month), and the survival rate was 100%, no one suffered from recurrence. ConclusionsFor some patients with complicated ASTT, CPB technique can provide chance to completely resect the tumors.