抄録
Desmoplastic fibroma (DF) is an extremely rare locally aggressive bone tumor. We report a case of multiple recurrence of a DF that developed in the right distal radius of an 11-year-old boy who had fallen from a slide and landed on his right hand. He sustained a fracture of the right distal radius, and intrafocal pinning from the dorsal side was performed at a nearby hospital. Six weeks after surgery, bone union was completed. However, during 10 months after surgery, his wrist gradually swelled and he visited our hospital. Radiography revealed a radiolucent lesion with expansive, well-defined, marginal sclerosis. Computed tomography and magnetic resonance imaging revealed that the tumor, measuring 40x30x27mm, was located in the distal radius, had destroyed the volar cortex, and extended into the soft tissue. The tumor was subsequently diagnosed as a DF by needle biopsy, and was treated by marginal excision, surgical curettage, and packing with artificial bone and an iliac bone autograft. However, the tumor recurred and had to be excised 3 times after the first operation. We observed the natural history of the tumor after the fourth recurrence because there was no loss of motor function and no symptoms.
DFs show a high rate of recurrence. It was difficult to extensively resect the tumor in the present case because of associated anatomical problems and potential loss of function after surgery, and the age of the patient discouraged us from using chemotherapy or radiation therapy. Preservation of motor function remains a high treatment priority, and a multidisciplinary approach involving chemotherapy, radiotherapy, and medication should be used in combination with wide resection whenever possible.
