Dowli A, Mattar A, Mashimo H, Huang Q, Cohen D, Fisichella P M, Lebenthal A
Division of Thoracic Surgery, Brigham and Women's Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA.
J Gastrointest Surg. 2014 Dec;18(12):2208-13. doi: 10.1007/s11605-014-2628-8. Epub 2014 Sep 5.
The majority of esophageal tumors arise from the mucosal layer; only 5 % are of mesenchymal origins. Of the latter, barely 0.5 % are liposarcomas. We present a case of an esophageal liposarcoma with a review of the literature.
A 64-year-old male was referred with 5 years of progressive dysphagia. Preoperative evaluation initially suggested a leiomyoma. The polypoid lesion was then resected through a cervical esophagotomy, once endoscopic resection proved to be not feasible. The definitive pathologic diagnosis confirmed a well-differentiated liposarcoma.
Esophageal liposarcomas are very rare and only 40 such cases have been reported in the literature. Most patients were male (80 %), the median age was 62 years (range 38-83 years), and the most common symptom was dysphagia (85 %). Only in two cases was a liposarcoma detected on preoperative biopsy. The most common histological subtype was well-differentiated liposarcoma. Overall, 77.5 % of the patients were successfully treated with surgery, 20 % endoscopically, and 2.5 % were ablated with CO2 laser.
Esophageal liposarcoma is an extremely rare tumor. The majority of patients are males; dysphagia is the most common initial symptom, and preoperative biopsy is unreliable. Because these tumors are pedunculated, well-circumscribed, and well-differentiated, they can be safely resected locally. All patients need long-term follow-up as this disease can recur many decades after treatment.
大多数食管肿瘤起源于黏膜层；只有5%起源于间叶组织。在后者中，脂肪肉瘤仅占0.5%。我们报告一例食管脂肪肉瘤病例并复习相关文献。
一名64岁男性因进行性吞咽困难5年前来就诊。术前评估最初提示为平滑肌瘤。在内镜切除不可行后，通过颈部食管切开术切除了息肉样病变。最终病理诊断证实为高分化脂肪肉瘤。
食管脂肪肉瘤非常罕见，文献中仅报道了40例此类病例。大多数患者为男性（80%），中位年龄为62岁（范围38 - 83岁），最常见的症状是吞咽困难（85%）。术前活检仅在两例中检测到脂肪肉瘤。最常见的组织学亚型是高分化脂肪肉瘤。总体而言，77.5%的患者通过手术成功治疗，20%通过内镜治疗，2.5%用二氧化碳激光消融。
食管脂肪肉瘤是一种极其罕见的肿瘤。大多数患者为男性；吞咽困难是最常见的首发症状，术前活检不可靠。由于这些肿瘤有蒂、边界清晰且分化良好，可以在局部安全切除。所有患者都需要长期随访，因为这种疾病在治疗后数十年可能复发。
