一例因腹膜后脂肪肉瘤肺转移行左下叶肺段切除术的病例报告。
A case report of left lower lobe segmentectomy for pulmonary metastasis from retroperitoneal liposarcoma.
作者信息
Yoshida Kazuhiro, Yoshida Masakazu, Haisa Minoru, Yukawa Takuro, Monobe Yasumasa, Naomoto Yoshio, Fukazawa Takuya, Yamatsuji Tomoki
机构信息
Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan.
Department of Pathology 1, Kawasaki Medical School, Okayama, 700-8505, Japan.
出版信息
Int J Surg Case Rep. 2019;61:169-173. doi: 10.1016/j.ijscr.2019.07.059. Epub 2019 Jul 26.
BACKGROUND
The principle treatment for retroperitoneal liposarcoma is surgical resection, however there are many cases of recurrence. In addition to local recurrence, retroperitoneal liposarcoma, particularly dedifferentiated liposarcoma is known to occasionally cause lung metastases.
CASE REPORT
A 72-year-old woman with a diagnosis of retroperitoneal liposarcoma and probable right upper lobe early pulmonary adenocarcinoma underwent sequential local tumor resection and right upper lobectomy. Twenty months after liposarcoma resection, a computed tomography (CT) scan of the chest revealed a nodule located in the left lower lobe. A CT-guided biopsy was performed and she was subsequently diagnosed with pulmonary metastasis from retroperitoneal liposarcoma. The nodule enlarged chronologically, however a left lower lobectomy could not be performed because respiratory function after the right upper lobectomy was not sufficient. Therefore, in order to preserve the left superior segment (S6), the basal segments (S8+S9+S10) were resected. Seven months after the surgery, she is living a self-reliant life without recurrence of liposarcoma.
CONCLUSION
Here we have reported a case of pulmonary metastasis from retroperitoneal liposarcoma following limited surgery. In cases where respiratory function is limited, lower lobe segmentectomy can be an effective treatment. For the treatment of a single pulmonary metastasis from retroperitoneal liposarcoma, metastasectomy was considered to be effective as long as no local recurrence was seen after initial primary tumor resection.
背景
腹膜后脂肪肉瘤的主要治疗方法是手术切除,但复发病例很多。除局部复发外,腹膜后脂肪肉瘤,特别是去分化脂肪肉瘤偶尔会发生肺转移。
病例报告
一名72岁女性,诊断为腹膜后脂肪肉瘤,可能合并右上叶早期肺腺癌,先后接受了局部肿瘤切除和右上叶切除术。脂肪肉瘤切除术后20个月,胸部计算机断层扫描(CT)显示左下叶有一个结节。进行了CT引导下活检,随后她被诊断为腹膜后脂肪肉瘤肺转移。结节随时间增大,但由于右上叶切除术后呼吸功能不足,无法进行左下叶切除术。因此,为了保留左上叶(S6),切除了基底段(S8+S9+S10)。手术后7个月,她过着自理生活,脂肪肉瘤未复发。
结论
我们报告了一例腹膜后脂肪肉瘤有限手术后发生肺转移的病例。在呼吸功能受限的情况下,下叶段切除术可能是一种有效的治疗方法。对于腹膜后脂肪肉瘤单发肺转移的治疗,只要在初次原发肿瘤切除后未见局部复发,转移灶切除术被认为是有效的。