Kasashima Hiroaki, Yamasaki Yoshio, Morimoto Yoshikazu, Akamaru Yusuke, Yasumasa Keigo, Kasugai Tsutomu, Yoshida Yasuyuki
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, 545-8585 Osaka, Japan.
Department of Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan.
Int J Surg Case Rep. 2015;7C:99-103. doi: 10.1016/j.ijscr.2015.01.002. Epub 2015 Jan 8.
Liposarcoma is one of the most common soft tissue sarcomas; however, early diagnosis is rare as the tumor remains difficult and unpalpable for a prolonged period of time.
Here we report the first case of retroperitoneal liposarcoma associated with pregnancy and expression of estrogen receptor. A 34-year-old woman experienced persistent abdominal distension after her first delivery. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large (40cm×35cm), solid, palpable abdominal mass with fat attenuation displacing the ascending colon and the right kidney to the left. Laparotomy and an en-bloc resection of the tumor were performed; further, right nephrectomy and adrenalectomy were required. Histopathology showed a well-differentiated liposarcoma; approximately 10-20% of the tumor cells were ER-positive.
Retroperitoneal liposarcoma associated with pregnancy is an extremely rare occurrence. Surgical resection is unquestionably the first choice of treatment, but complete resection is sometimes impossible due to the volume and depth of invasion of the tumor. In such cases, additional therapy for liposarcoma is important to improve prognosis. Thus, this report highlights the need for further research into hormone therapy.
Retroperitoneal liposarcoma has a high local recurrence rate due to the difficulty in complete surgical resection; therefore, additional hormone therapy is important for improving the prognosis.
脂肪肉瘤是最常见的软组织肉瘤之一；然而，由于肿瘤在很长一段时间内难以察觉且无法触及，早期诊断很少见。
我们在此报告首例与妊娠相关的腹膜后脂肪肉瘤及雌激素受体表达情况。一名34岁女性在首次分娩后持续腹胀。计算机断层扫描（CT）和磁共振成像（MRI）显示一个巨大（40cm×35cm）、实性、可触及的腹部肿块，其脂肪密度影将升结肠和右肾向左推移。行剖腹手术并整块切除肿瘤；此外，还需要进行右肾切除术和肾上腺切除术。组织病理学显示为高分化脂肪肉瘤；约10 - 20%的肿瘤细胞雌激素受体呈阳性。
与妊娠相关的腹膜后脂肪肉瘤极为罕见。手术切除无疑是首选治疗方法，但由于肿瘤的体积和浸润深度，有时无法完全切除。在这种情况下，脂肪肉瘤的辅助治疗对于改善预后很重要。因此，本报告强调了对激素治疗进行进一步研究的必要性。
由于手术完全切除困难，腹膜后脂肪肉瘤局部复发率高；因此，辅助激素治疗对于改善预后很重要。
