Eren Filiz, Gürses Murat Serdar, Inanir Nursel Türkmen, Eren Bülent, Vojtisek Tomas
Department of Bursa Morgue, Council of Forensic Medicine of Turkey, Bursa, Turkey.
Department of Forensic Medicine, Uludağ University Medical Faculty, Bursa, Turkey.
Maedica (Bucur). 2015 Jun;10(2):140-142.
Liposarcoma is very rare mesenchymal tumor that occurs in deep soft tissue and mostly seen in limbs and retroperitoneum, accounts for 24% of extremity and 45% of retroperitoneal soft tissue sarcomas. Retroperitoneal liposarcomas are typically present with advanced disease and often carry a poor prognosis. Retroperitoneal liposarcomas grow slowly in the very expandable retroperitoneal space in the deeply hidden and clinically silent therefore diagnosis is usually made late. Liposarcomas have five histological subtypes; well-differentiated liposarcoma (WDLS), dedifferentiated liposarcoma (DDLS), pleomorphic, myxoid and round cell liposarcoma. Our case is 81-year-old male who was found dead in the village homeless shelter. This was classified as a suspicious death and transferred to our service for autopsy. The external examination revealed rectal prolapse, abdominal distension and scrotal swelling. The internal autopsy showed green membrane on the peritoneum, brown smelly contents in the abdominal space, a perforation area 1.5x1 cm in size that in the first part of the duodenum and the dimension of tumor was 48x30x6 cm in the retroperitoneal space. The pathological report was dedifferentiated liposarcoma. We present a rare case of a dedifferentiated retroperitoneal liposarcoma with duodenal ulcer perforation.
脂肪肉瘤是一种非常罕见的间叶组织肿瘤，发生于深部软组织，多见于四肢和腹膜后，分别占四肢软组织肉瘤的24%和腹膜后软组织肉瘤的45%。腹膜后脂肪肉瘤通常在疾病晚期出现，预后往往较差。腹膜后脂肪肉瘤在极具扩展性的腹膜后间隙中生长缓慢，深藏且临床症状不明显，因此通常在晚期才得以诊断。脂肪肉瘤有五种组织学亚型：高分化脂肪肉瘤（WDLS）、去分化脂肪肉瘤（DDLS）、多形性、黏液样和圆形细胞脂肪肉瘤。我们的病例是一名81岁男性，被发现死于村里的收容所。这被归类为可疑死亡并转至我们科室进行尸检。外部检查发现直肠脱垂、腹胀和阴囊肿胀。内部尸检显示腹膜有绿色薄膜，腹腔内有棕色有臭味的内容物，十二指肠第一部有一个1.5×1厘米大小的穿孔区域，腹膜后间隙肿瘤大小为48×30×6厘米。病理报告为去分化脂肪肉瘤。我们报告一例罕见的伴有十二指肠溃疡穿孔的腹膜后去分化脂肪肉瘤病例。
