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保留肾单位的巨大腹膜后脂肪肉瘤:病例报告及文献复习

Kidney sparing giant retroperitoneal liposarcoma: Case report and literature review.

作者信息

Argadjendra Masjensen, Napitupulu Rudi, Yudadi Redemptus, Hoetama Sakti, Wibowo Heru Seno

机构信息

Hang Tuah University, Surabaya, Indonesia.

Department of Digestive Surgery, Dr Ramelan Navy Hospital Surabaya, Surabaya, Indonesia.

出版信息

Int J Surg Case Rep. 2019;56:70-73. doi: 10.1016/j.ijscr.2019.02.008. Epub 2019 Feb 21.

Abstract

INTRODUCTION

Liposarcoma is the most common variant of soft tissue sarcoma. It often originates in retroperitoneum or perirenal fat. Early diagnosis is extremely difficult due to its location in the retroperitoneum that allows for room for growth. Symptoms would only occur when the tumor becomes very large and/or invades into adjacent organs.

PRESENTATION OF CASE

We report a case of a 30 years old woman who underwent surgical resection for a well-differentiated liposarcoma. CT scan revealed that the mass invaded the left perirenal fascia and displaced the descending colon, pancreas, and duodenum. Complete resection of tumour masses were performed and we opted against nephrectomy due to the tumor's histologic type, the patient's young age, and increased morbidity.

DISCUSSION

Treatment for Retroperitoneal Liposarcoma involves R0 resection. In cases where the tumor invades into a nearby organ, it is necessary to weigh the benefit of free margin resection against the adversity of medical complication and quality of life loss.

CONCLUSSION

Due to its rate of recurrence, a life long follow up and routine assessment of intraabdominal mass should be integrated into clinical practice in liposarcoma patients.

摘要

引言

脂肪肉瘤是软组织肉瘤最常见的变体。它常起源于腹膜后或肾周脂肪。由于其位于腹膜后,有生长空间,早期诊断极为困难。只有当肿瘤变得非常大或侵犯邻近器官时才会出现症状。

病例介绍

我们报告一例30岁女性,因高分化脂肪肉瘤接受手术切除。CT扫描显示肿块侵犯左肾周筋膜,推移降结肠、胰腺和十二指肠。由于肿瘤的组织学类型、患者年轻以及发病率增加,我们选择不行肾切除术,而是对肿瘤肿块进行了完整切除。

讨论

腹膜后脂肪肉瘤的治疗包括R0切除。在肿瘤侵犯附近器官的情况下,有必要权衡切缘阴性切除的益处与医疗并发症和生活质量下降的不利因素。

结论

由于其复发率,对脂肪肉瘤患者应将终身随访和腹腔内肿块的常规评估纳入临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3c3/6411585/5087a92da04a/gr1.jpg

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