Cavallaro Andrea, Catania Vito, Cavallaro Marco, Di Mauro Davide, Cappellani Alessandro
Università degli Studi di Catania, Azienda Ospedaliero Universitaria Policlinico "Gaspare Rodolico" Catania, Unità operativa di Chirurgia dell'Apparato Digerente.
Ann Ital Chir. 2007 Nov-Dec;78(6):515-9.
Retroperitoneal sarcomas (RS) are a rare group of malignant soft-tissue tumors. They generally grow until they reach large size before becoming symptomatic, often involving surrounding structures.
The paper reports the case of a particularly large retroperitoneal liposarcoma (diameter: 48 x 44 x 32 cm, weight: 13.500 kg) surgically treated in a 92-year old woman: the patient tolerated the procedure well and was discharged after a short hospitalization. The paper, moreover, focuses on the diagnostic and therapeutic aspects of this tumour. The need for radical surgery to remove the entire mass is certain, even if it is particularly large; furthermore, the patient must be carefully monitored since retroperitoneal recurrence is frequent and must be treated, wherever possible, surgically. After a review of the literature there is an evidence that higher tumor grade, non-liposarcoma histology, advanced stage, incomplete surgical resection, and microscopic infiltration of surgery resection margins were found to be significantly negative prognostic factors.
The study underlines the role of liposarcoma surgery management in order to offer the best chance of long-term survival and, especially on elderly patients, a better quality of life.
腹膜后肉瘤(RS)是一组罕见的恶性软组织肿瘤。它们通常在出现症状之前会一直生长到很大的尺寸,常常累及周围结构。
本文报道了一例在一名92岁女性患者中手术治疗的特别巨大的腹膜后脂肪肉瘤(直径:48×44×32厘米,重量:13.500千克)的病例:患者对手术耐受良好,短期住院后出院。此外,本文重点关注了该肿瘤的诊断和治疗方面。即使肿瘤特别大,也肯定需要进行根治性手术以切除整个肿块;此外,由于腹膜后复发很常见且必须尽可能通过手术治疗,因此必须对患者进行仔细监测。在对文献进行综述后发现,肿瘤分级较高、非脂肪肉瘤组织学类型、晚期、手术切除不完全以及手术切缘的显微镜下浸润是显著不利的预后因素。
该研究强调了脂肪肉瘤手术管理的作用,以便提供最佳的长期生存机会,尤其是对老年患者而言,能提高生活质量。