Desaki Ryosuke, Tabata Masami, Nakamura Shinichiro, Nakamura Shunta, Segi Yuki, Fujimura Yu, Kobayashi Motoyuki, Ohsawa Ichiro, Kato Kenji, Iwata Makoto, Mizutani Minoru, Sugimoto Hiroko, Sanda Takayuki
Dept. of Surgery, Matsusaka Central General Hospital.
Gan To Kagaku Ryoho. 2020 Mar;47(3):528-530.
A 71-year-old woman visited our hospital for the examination and treatment of retroperitoneal tumor. CT showed a retroperitoneal tumor extending to the posterior mediastinum; the tumor pressed the IVC and widely abutted the aorta. On MRI, the tumor showed low intensity on T1WI and high intensity on T2WI and DWI. However, the tumor did not show signal reduction on an ADC map. PET-CT showed high accumulation at the tumor. The patient was diagnosed with sarcoma arising from the retroperitoneum. The tumor located on a part of the diaphragm was resected. Histological examination revealed spindle cells with atypical nuclear and multinuclear cells. There were no lesions of well-differentiated liposarcoma. Both CDK4 and MDM2 tested positive on immunohistological staining. Histopathologically, the tumor was diagnosed as dedifferentiated liposarcoma without any well-differentiated liposarcoma component. The postoperative course was uneventful, and she was discharged on the 13th day after surgery. Two months after surgery, no recurrence has been detected.
一名71岁女性因腹膜后肿瘤的检查和治疗前来我院就诊。CT显示腹膜后肿瘤延伸至后纵隔；肿瘤压迫下腔静脉并广泛贴近主动脉。在MRI上，肿瘤在T1WI上呈低信号，在T2WI和DWI上呈高信号。然而，肿瘤在表观扩散系数（ADC）图上未显示信号减低。PET-CT显示肿瘤处有高摄取。患者被诊断为腹膜后肉瘤。位于膈肌一部分的肿瘤被切除。组织学检查显示有非典型核的梭形细胞和多核细胞。未见高分化脂肪肉瘤病变。免疫组织化学染色显示CDK4和MDM2均呈阳性。组织病理学上，该肿瘤被诊断为无任何高分化脂肪肉瘤成分的去分化脂肪肉瘤。术后病程顺利，患者术后第13天出院。术后两个月，未检测到复发。
