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成功手术治疗累及胰腺、右肾、腹主动脉和下腔静脉的巨大腹膜后脂肪肉瘤。

Successful surgical treatment for huge retroperitoneal liposarcoma involving the pancreas, right kidney, abdominal aorta and inferior vena cava.

作者信息

Tanaka Mariko, Kawahara Toshiyasu, Nishikoshi Takahiro, Hagiwara Masahiro, Imai Koji, Hasegawa Kimiharu, Koya Atsuhiro, Matsuno Naoto, Takei Hidehiro, Azuma Nobuyoshi, Furukawa Hiroyuki

机构信息

Department of Surgery, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa city, Hokkaido 078-8510, Japan.

Department of Pathology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa city, Hokkaido 078-8510, Japan.

出版信息

J Surg Case Rep. 2017 Nov 23;2017(11):rjx200. doi: 10.1093/jscr/rjx200. eCollection 2017 Nov.

Abstract

Retroperitoneal liposarcoma is a rare neoplasm that often involves other organs and major blood vessels. Complete surgical resection with negative margins is the only potential curative treatment. Here, we report the case of a patient with a large retroperitoneum liposarcoma that was removed by resection of the descending abdominal aorta and infrahepatic inferior vena cava, right nephrectomy and pancreatoduodenectomy following creation of an extra anatomical femoro-femoral crossover bypass after left axillo-left femoral bypass. The patient developed leg edema for a few weeks after surgery but this condition was gradually resolved with diuretics. Otherwise, no serious postoperative complication was observed, and the patient was discharged at 37 days after surgery. There has been no evidence of recurrence for 16 months. In conclusion, radical surgical resection is a possible therapeutic option for retroperitoneal liposarcoma involving major vessels or other organs, and may improve survival if negative resection margins can be achieved.

摘要

腹膜后脂肪肉瘤是一种罕见的肿瘤,常累及其他器官和主要血管。切缘阴性的完整手术切除是唯一可能的治愈性治疗方法。在此,我们报告一例巨大腹膜后脂肪肉瘤患者的病例,该患者在左腋-左股旁路术后建立解剖外股-股交叉旁路后,通过切除降主动脉和肝下下腔静脉、右肾切除术和胰十二指肠切除术成功切除肿瘤。患者术后出现腿部水肿数周,但通过利尿剂治疗后病情逐渐缓解。除此之外,未观察到严重的术后并发症,患者在术后37天出院。术后16个月无复发迹象。总之,根治性手术切除是治疗累及主要血管或其他器官的腹膜后脂肪肉瘤的一种可行治疗选择,如果能实现阴性切缘,则可能提高生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72aa/5798155/da7fe143eda1/rjx200f01.jpg

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