DePaolo C J, Foster W S, Dabezies E J, D'Ambrosia R D
Department of Orthopedics, Louisiana State University School of Medicine, New Orleans.
Orthopedics. 1988 Sep;11(9):1263-76. doi: 10.3928/0147-7447-19880901-08.
A 54-year-old black man presented with a soft-tissue sarcoma of the left anterior thigh. Surgical staging studies and initial biopsy results identified the lesion as a grade IIB pleomorphic liposarcoma. After radical hip disarticulation, follow up pathologic studies of the disarticulated limb showed the tumor to be confined to the anterior compartment of the left thigh without extracompartmental extension. The post-excisional surgical pathology report identified at least four different malignant mesenchymal elements: liposarcoma, myosarcoma, chondrosarcoma, and extraosseous osteogenic sarcoma. The sarcoma was therefore reclassified as a malignant mesenchymoma. The fact that the tumor was found to be intracompartmental at the time of surgery changed the staging of the tumor to stage IIA. A radical surgical margin, as recommended by Enneking, remained the treatment of choice. Three months postoperatively, the patient had chest pain and dyspnea. Chest films revealed multiple pulmonary nodules and the patient died of pneumonia 3 months later.
一名54岁的黑人男性因左大腿前部软组织肉瘤就诊。手术分期检查和初始活检结果确定该病变为IIB级多形性脂肪肉瘤。在进行根治性髋关节离断术后，对离断肢体的后续病理研究显示肿瘤局限于左大腿前侧间室，无间室外扩展。切除术后的手术病理报告确定至少有四种不同的恶性间充质成分：脂肪肉瘤、肌肉肉瘤、软骨肉瘤和骨外骨肉瘤。因此，该肉瘤被重新分类为恶性间叶瘤。手术时发现肿瘤位于间室内这一事实将肿瘤分期改为IIA期。按照恩宁克的建议，手术切缘阴性仍然是首选治疗方法。术后三个月，患者出现胸痛和呼吸困难。胸部X光片显示多个肺结节，患者于三个月后死于肺炎。
