Okabayashi Takehiro, Shima Yasuo, Iwata Jun, Sumiyoshi Tatsuaki, Kozuki Akihito, Tokumaru Teppei, Hata Yasuhiro, Noda Yoshihiro, Inagaki Takeshi, Morishita Saori, Morita Masanori
Department of Gastroenterological Surgery, Kochi Health Sciences Center, Japan.
Intern Med. 2013;52(24):2753-7. doi: 10.2169/internalmedicine.52.1230.
A 55-year-old man suffering from melena was admitted to our hospital. A blood test showed severe anemia. Contrast-enhanced computed tomography (CT) revealed a huge lesion in the duodenum and dilatation of the common bile duct. Upper gastrointestinal endoscopy also identified hemorrhaging from the tumor in the duodenum. Due to the low density of the tumor mass, we performed emergency pylorus-preserving pancreaticoduodenectomy. Histology revealed an area of well-differentiated liposarcoma as well as an area of high-grade spindle cells and pleomorphic sarcoma without obvious differentiation. The final pathological diagnosis was dedifferentiated liposarcoma. This is the first case report of primary liposarcoma of the duodenum.
一名55岁患有黑便的男性被收治入院。血液检查显示严重贫血。增强计算机断层扫描（CT）显示十二指肠有巨大病变，胆总管扩张。上消化道内镜检查也发现十二指肠肿瘤出血。由于肿瘤肿块密度较低，我们进行了急诊保留幽门的胰十二指肠切除术。组织学检查显示有一个高分化脂肪肉瘤区域以及一个高级别梭形细胞和多形性肉瘤区域，无明显分化。最终病理诊断为去分化脂肪肉瘤。这是十二指肠原发性脂肪肉瘤的首例病例报告。
