Sato Daisuke, Suga Hirotaka, Takushima Akihiko
Department of Plastic Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Dermatol Surg. 2018 Aug;44(8):1065-1069. doi: 10.1097/DSS.0000000000001533.
On rare occasions, a lesion preoperatively diagnosed as a lipoma is ultimately diagnosed as a liposarcoma. It is important to differentiate liposarcomas from lipomas preoperatively.
To examine characteristic features of liposarcomas preoperatively diagnosed as lipomas.
Patients (n = 637) who underwent resection of tumors preoperatively diagnosed as lipomas from January 2006 to October 2016 were retrospectively reviewed.
Based on pathological examination, 8 of 637 lesions were diagnosed as liposarcomas postoperatively. All the liposarcomas were well-differentiated liposarcomas. The rate of male patients was higher (87.5% vs 38.9%) and the size of tumors was larger (8.75 vs 4.64 cm) in these cases than in accurately diagnosed lipoma cases. On imaging, nonfatty septa were more frequently observed (71.4% vs 20.0%) and were thicker (2.22 vs 1.33 mm) than in true lipoma cases.
If the patient with a lipomatous tumor is male and the tumor is large, we should consider the possibility of it being a liposarcoma. A thick internal septum in the image findings is a good predictor of malignancy.
在极少数情况下,术前诊断为脂肪瘤的病变最终被诊断为脂肪肉瘤。术前区分脂肪肉瘤和脂肪瘤很重要。
研究术前诊断为脂肪瘤的脂肪肉瘤的特征。
回顾性分析2006年1月至2016年10月期间接受术前诊断为脂肪瘤的肿瘤切除术的637例患者。
根据病理检查,637例病变中有8例术后诊断为脂肪肉瘤。所有脂肪肉瘤均为高分化脂肪肉瘤。与准确诊断为脂肪瘤的病例相比,这些病例中的男性患者比例更高(87.5%对38.9%),肿瘤大小更大(8.75对4.64厘米)。在影像学上,与真正的脂肪瘤病例相比,非脂肪间隔更常见(71.4%对20.0%)且更厚(2.22对1.33毫米)。
如果脂肪瘤样肿瘤患者为男性且肿瘤较大,我们应考虑其为脂肪肉瘤的可能性。影像学检查中厚的内部间隔是恶性肿瘤的良好预测指标。