Voulliaume D, Vasseur C, Delaporte T, Delay E
Service de chirurgie plastique et des brûlés, centre hospitalier St-Joseph St-Luc, 20, quai Claude-Bernard, 69007, Lyon, France.
Ann Chir Plast Esthet. 2003 Jun;48(3):187-93. doi: 10.1016/s0294-1260(03)00043-8.
Liposuction is a simple and elegant way to treat fatty excess; it has been even used for the treatment of lipomas and some gynecomasties. The goal of this article is to present 2 patients with an unusual complication of this use: the liposuction of a malignant tumor. The first patient consulted following the liposuction of a "gynecomasty", which was in fact a breast cancer. The second was treated by liposuction for an ankle "lipoma"; it proved to be a liposarcoma. In order to avoid liposuction and dissemination of a malignant tumor, the pre-operative investigations have to search clinical peculiarities evoking the diagnosis: an unilateral "gynecomasty", irregular, hard or painless, in a 50-years-old patient, must incite the surgeon to perform a classical excision, just as a recurrent "lipoma", deeply located, voluminous or quickly extensive, situated on the limbs or in the humeroscapular area. Paraclinic investigations may be indicated; doubtful cases must be right away rejected for liposuction, and treated by a surgical excision with strict safety margins and complete anatomopathologic examination of the lesion. Liposuction has become a very useful technique for the plastic surgeon; however, we must not forget, despite of its many advantages the risk for dissemination of an unknown malignant tumor. Every surgeon must keep it in mind and prefer a surgical removal in atypical cases.
抽脂术是一种治疗脂肪过多的简单而有效的方法；它甚至已被用于治疗脂肪瘤和某些男性乳房肥大症。本文的目的是介绍2例因这种用途而出现异常并发症的患者：对恶性肿瘤进行抽脂。首例患者在接受“男性乳房肥大症”抽脂术后前来咨询，而实际上那是一例乳腺癌。第二例患者因脚踝“脂肪瘤”接受抽脂治疗；结果证实是脂肪肉瘤。为避免对恶性肿瘤进行抽脂并导致其扩散，术前检查必须寻找提示诊断的临床特征：一名50岁患者单侧的、不规则的、坚硬的或无痛的“男性乳房肥大症”，必须促使外科医生进行经典切除，同样，对于位于四肢或肩胛肱骨区域的复发性“脂肪瘤”，若位置深、体积大或迅速增大，也应如此。可能需要进行辅助检查；可疑病例必须立即排除抽脂治疗，而应采用具有严格安全切缘的手术切除并对病变进行完整的解剖病理学检查。抽脂术已成为整形外科医生非常有用的一项技术；然而，尽管它有许多优点，但我们绝不能忘记存在未知恶性肿瘤扩散的风险。每位外科医生都必须牢记这一点，在非典型病例中更倾向于手术切除。
