Hashimoto Shintaro, Arai Junichi, Nishimuta Masato, Matsumoto Hirofumi, Fukuoka Hidetoshi, Muraoka Masashi, Nakashima Masahiro, Yamaguchi Hiroyuki
Department of Surgery, Japan Community Health care Organization (JCHO), Isahaya General Hospital, Japan.
Department of Pathology, Japan Community Health care Organization (JCHO), Isahaya General Hospital, Japan.
Int J Surg Case Rep. 2019;61:20-25. doi: 10.1016/j.ijscr.2019.06.067. Epub 2019 Jul 8.
Liposarcoma usually occurs in the retroperitoneum and limbs. Liposarcoma of the greater omentum is rare, and most information of such liposarcomas has come from case reports.
A 60-year-old woman was found to have an 8-cm intra-abdominal mass (suspected lipoma) by computed tomography. At the age of 63 years, she underwent a medical examination and a mass was palpated in the abdomen. Contrast-enhanced computed tomography and magnetic resonance imaging confirmed the presence of a huge intra-abdominal tumor with the omental artery passing through the mass. The tumor was simply resected. Histopathologically, the tumor was diagnosed as a well-differentiated liposarcoma, and the resection margin was microscopically negative. The patient had developed no recurrence or complications 9 months postoperatively.
Liposarcoma of the greater omentum is rare, and differentiation of liposarcoma from other tumors is challenging. Adjuvant therapy has not been established as an effective treatment, and radical (R0) resection of the tumor is recommended. Our case of liposarcoma of the greater omentum was surgically managed with good outcomes.
The diagnosis of liposarcoma with a lipomatous tumor is challenging, and resection should be considered for huge intra-abdominal lipomatous tumors.
脂肪肉瘤通常发生于腹膜后和四肢。大网膜脂肪肉瘤罕见，此类脂肪肉瘤的多数信息来自病例报告。
一名60岁女性经计算机断层扫描发现腹内有一个8厘米的肿块（疑似脂肪瘤）。63岁时，她接受体检，腹部可触及一个肿块。增强计算机断层扫描和磁共振成像证实腹内存在一个巨大肿瘤，网膜动脉穿过该肿块。肿瘤被简单切除。组织病理学检查显示，该肿瘤被诊断为高分化脂肪肉瘤，切除边缘显微镜下呈阴性。术后9个月，患者未出现复发或并发症。
大网膜脂肪肉瘤罕见，鉴别脂肪肉瘤与其他肿瘤具有挑战性。辅助治疗尚未被确立为有效治疗方法，建议对肿瘤进行根治性（R0）切除。我们的大网膜脂肪肉瘤病例通过手术治疗取得了良好效果。
脂肪肉瘤合并脂肪瘤样肿瘤的诊断具有挑战性，对于腹内巨大脂肪瘤样肿瘤应考虑进行切除。
