Eyermann C, Raguin T, Hemar P, Debry C
Service d'ORL et de chirurgie cervico-faciale, HUS, hôpital de Hautepierre, avenue Molière, 67000 Strasbourg, France.
Service d'ORL et de chirurgie cervico-faciale, HUS, hôpital de Hautepierre, avenue Molière, 67000 Strasbourg, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1):63-65. doi: 10.1016/j.anorl.2017.07.001. Epub 2017 Jul 29.
Liposarcoma of the hypopharynx is extremely rare, as only 28 cases have been reported in the literature. The cardinal symptom of liposarcoma is progressively worsening dysphagia.
The authors report the case of a 71-year-old man who presented with dysphagia, marked weight loss over several weeks and an episode of exteriorization of a solid mass from the mouth during an episode of vomiting. Imaging revealed a fat density intra-oesophageal mass. Panendoscopy and upper gastrointestinal endoscopy visualized the pedunculated tumour in the left piriform sinus, which was able to be exteriorized via the mouth. The tumour was then resected endoscopically at its hypopharyngeal insertion pedicle. Histological examination of the operative specimen concluded on well-differentiated benign liposarcoma.
Well-differentiated liposarcoma is the most common form of liposarcoma, but is only exceptionally reported in the hypopharynx. The main symptoms are related to compression of adjacent structures. Imaging findings are nonspecific. Only histological examination can distinguish liposarcoma from other benign oesophageal tumours. Standard treatment consists of wide, complete resection, which is not always possible in the neck. Long-term follow-up of these patients is essential in order to rapidly detect recurrence.
下咽脂肪肉瘤极为罕见,文献中仅报道过28例。脂肪肉瘤的主要症状是吞咽困难逐渐加重。
作者报告了一例71岁男性患者,该患者出现吞咽困难、数周内体重明显减轻,且在一次呕吐发作时口腔内有一实性肿物脱出。影像学检查显示食管内有一脂肪密度肿物。经口内镜检查和上消化道内镜检查发现左侧梨状窝有一有蒂肿瘤,可经口腔将其脱出。然后在内镜下于下咽肿物蒂部将肿瘤切除。手术标本的组织学检查结果为高分化良性脂肪肉瘤。
高分化脂肪肉瘤是脂肪肉瘤最常见的类型,但在下咽部位仅偶尔有报道。主要症状与邻近结构受压有关。影像学表现无特异性。只有组织学检查才能将脂肪肉瘤与其他良性食管肿瘤区分开来。标准治疗方法是广泛、完整切除,但在颈部并不总是可行。对这些患者进行长期随访对于快速发现复发至关重要。