Ki E Y, Park S T, Park J S, Hur S Y
Department of Obstetrics and Gynecology, The Catholic Medical University of Korea, Seoul St Mary's Hospital, Seoul, Korea.
Eur J Gynaecol Oncol. 2012;33(3):318-20.
Soft tissue sarcomas are rare and account for less than 1% of all newly diagnosed malignancies. One-third of malignant tumors arising in the retroperitoneum are sarcomas. Liposarcoma is the most common soft tissue sarcoma and retroperitoneal sarcoma. Liposarcoma accounts for at least 20% of all sarcomas in adults and up to 41% of all retroperitoneal sarcomas. Here we present the case of a huge retroperitoneal liposarcoma and a brief literature review.
A 34-year-old woman was referred to our hospital from a local clinic, because of abdominal distention, pain, and palpable mass. On admission we found that her abdomen was markedly distended. Computed tomography showed a the huge left ovarian mass that occupied almost the entire abdominal cavity. The mass consisted mainly of fat, and calcified material. She was operated under the diagnosis of a huge teratoma. The tumor was located in the retroperitoneal cavity and it abutted the left adnexa. The retroperitoneal tumor, including the left adnexa was removed. The tumor measured 22 x 15 x 11 cm, and showed many histological and pathological findings. On the basis of the histopathological finding, the tumor was diagnosed as a dedifferentiated liposarcoma of the retroperitoneum. The patient is presently undergoing radiation therapy.
In retroperitoneal liposarcoma, histological subtype, incomplete resection, contiguous organ resection, and older age are strongly associated with tumor-related mortality. For liposarcoma, it is necessary to customize the treatment strategy on a case-by-case basis.
软组织肉瘤较为罕见,占所有新诊断恶性肿瘤的比例不到1%。腹膜后出现的恶性肿瘤中有三分之一是肉瘤。脂肪肉瘤是最常见的软组织肉瘤和腹膜后肉瘤。脂肪肉瘤至少占成人所有肉瘤的20%,在所有腹膜后肉瘤中占比高达41%。在此,我们报告一例巨大腹膜后脂肪肉瘤病例并进行简要文献回顾。
一名34岁女性因腹胀、腹痛及可触及肿块从当地诊所转诊至我院。入院时我们发现她的腹部明显膨隆。计算机断层扫描显示左侧卵巢有一个巨大肿块,几乎占据了整个腹腔。肿块主要由脂肪和钙化物质组成。她在被诊断为巨大畸胎瘤的情况下接受了手术。肿瘤位于腹膜后腔,与左侧附件相邻。包括左侧附件在内的腹膜后肿瘤被切除。肿瘤大小为22×15×11厘米,呈现出许多组织学和病理学特征。根据组织病理学检查结果,该肿瘤被诊断为腹膜后去分化脂肪肉瘤。患者目前正在接受放射治疗。
在腹膜后脂肪肉瘤中,组织学亚型、切除不完全、相邻器官切除以及年龄较大与肿瘤相关死亡率密切相关。对于脂肪肉瘤,有必要根据具体病例制定个性化的治疗策略。