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腹盆腔间叶性肿瘤的综合影像学-病理学研究及治疗指南更新:第 2 部分

Comprehensive Review of Abdominopelvic Mesenchymal Tumors With Radiologic Pathologic Correlation and Update on Current Treatment Guidelines-Part 2.

机构信息

Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.

Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.

出版信息

Semin Ultrasound CT MR. 2020 Apr;41(2):239-259. doi: 10.1053/j.sult.2020.03.003. Epub 2020 Mar 14.

Abstract

Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies accounting for only 1% of all solid adult malignancies. These have been categorized in 12 broad groups by the World Health Organization (WHO) with their recent update in 2013. Majority of them lack specific imaging features serving as imaging conundrums for a radiologist. These are often large masses at presentation as they are asymptomatic or cause vague clinical symptoms. These tumors are challenging for surgeons as well as they find it difficult to achieve complete resection because of complex intra-abdominal anatomy and their close relationship with critical structures. Often, a multidisciplinary approach is required to decide on the most appropriate management for these complex cases so as to provide optimal patient care. Knowledge of the WHO classification, pathologic features, and treatment options available helps the radiologist make a meaningful contribution in multidisciplinary discussions of such cases and overall patient care. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor are the 3 most common primary intra-abdominal sarcomas. In part 1 of this article, general features of soft-tissue sarcomas and some of the common tumors from WHO category 1-4 found in abdomen and pelvis are discussed. Part 2 will focus on common tumors from remainder of the WHO categories.

摘要

软组织肉瘤是一组罕见的间叶恶性肿瘤,仅占所有成人实体恶性肿瘤的 1%。这些肿瘤在世界卫生组织(WHO)的分类中被分为 12 个广泛的组别,最近在 2013 年进行了更新。其中大多数缺乏特定的影像学特征,这对放射科医生来说是一个影像学难题。这些肿瘤通常在就诊时就是巨大肿块,因为它们是无症状的,或者引起模糊的临床症状。由于复杂的腹腔解剖结构和与关键结构的密切关系,这些肿瘤对外科医生来说也是一个挑战,他们很难实现完全切除。通常需要多学科方法来决定这些复杂病例的最佳治疗方案,以提供最佳的患者护理。了解 WHO 分类、病理特征和可用的治疗选择有助于放射科医生在这些病例的多学科讨论和整体患者护理中做出有意义的贡献。脂肪肉瘤(高分化和去分化脂肪肉瘤)、平滑肌肉瘤和胃肠道间质瘤是 3 种最常见的原发性腹腔内肉瘤。在本文的第 1 部分,我们将讨论软组织肉瘤的一般特征以及在腹部和骨盆中发现的来自 WHO 分类 1-4 的一些常见肿瘤。第 2 部分将重点介绍来自其余 WHO 类别的常见肿瘤。

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