Arakawa Yusuke, Yoshioka Kazuo, Kamo Hitomi, Kawano Koichiro, Yamaguchi Takeshi, Sumise Yuko, Okitsu Natsu, Ikeyama Shizuo, Morimoto Kojiro, Nakai Yoshihiro, Tashiro Seiki
Department of Surgery, Taoka Hospital, Tokushima, Japan.
J Med Invest. 2013;60(1-2):164-8. doi: 10.2152/jmi.60.164.
A 74-year-old male with abdominal pain was admitted to the emergency room in our hospital. The high value of serum amylase was shown in his blood test. The postcontrast computed tomography (CT) showed the huge retroperitoneal tumor with a thin-walled mass occupying most of the part of the right retroperitoneal space. The tumor spread into the soft tissues around the pancreas; as a result, the duodenum was compressed and the pancreas was displaced to the right side. The irregular pancreatic outline, obliterated peripancreatic fatty tissue and fluid in the left anterior pararenal space were revealed, so acute pancreatitis was diagnosed. The diagnostic biopsy of retroperitoneal tumor was done, and the pathological findings of retroperitoneal mass revealed dedifferentiated liposarcoma. The medical treatment against acute pancreatitis was performed firstly. After the patient recovered from that, the surgical resection of the tumor with the right kidney and right adrenal gland was completed successfully. The patient remained well, without any evidence of recurrence three months after surgery. However, the histology showed dedifferentiated liposarcoma; therefore, postoperative regular examination is necessary.
一名74岁腹痛男性被收入我院急诊室。其血液检查显示血清淀粉酶值升高。增强计算机断层扫描(CT)显示巨大的腹膜后肿瘤,为薄壁肿块,占据了右腹膜后间隙的大部分区域。肿瘤蔓延至胰腺周围软组织,导致十二指肠受压,胰腺向右移位。可见胰腺轮廓不规则、胰腺周围脂肪组织消失以及左肾前间隙有液体,因此诊断为急性胰腺炎。对腹膜后肿瘤进行了诊断性活检,腹膜后肿块的病理结果显示为去分化脂肪肉瘤。首先对急性胰腺炎进行了药物治疗。患者康复后,成功完成了肿瘤连同右肾和右肾上腺的手术切除。术后三个月患者情况良好,无任何复发迹象。然而,组织学显示为去分化脂肪肉瘤,因此术后需要定期检查。