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最大直径达37厘米的巨大腹膜后脂肪肉瘤:一例报告并文献复习

Giant retroperitoneal liposarcoma with a maximum diameter of 37 cm: a case report and review of literature.

作者信息

Xu Chi, Ma Zhiqiang, Zhang Hui, Yu Jianchun, Chen Shuguang

机构信息

Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Ann Transl Med. 2020 Oct;8(19):1248. doi: 10.21037/atm-20-1714.

Abstract

Retroperitoneal liposarcoma is a rare malignancy derived from adipocytes. They can grow to large sizes before inducing clinical symptoms. Giant retroperitoneal liposarcoma with a diameter over 30 centimeters is extremely rare. So far, only 13 cases of giant retroperitoneal liposarcoma with a diameter greater than 30 cm have been reported. There is very little experience in the treatment of these bulky tumors. Herein, we report a 65-year-old male patient diagnosed with giant retroperitoneal liposarcoma. The patient underwent successful complete surgical resection. The tumor was found to occupy almost the entire abdominal cavity, measuring 37.0 cm × 32.0 cm × 26.5 cm in size and 21.0 kg in weight. Histopathological analysis indicated a grade I, well-differentiated liposarcoma. The patient was discharged uneventfully, and no sign of recurrence was observed at 12-month follow-up. Moreover, we reviewed 13 literatures in English published on PubMed database regarding retroperitoneal liposarcoma greater than 30 cm in diameter. The analysis suggests that size alone should not be considered as a contraindication to surgical resection. Combined resection of adjacent organs is necessary if local invasion is confirmed. The role of adjuvant radio or chemotherapy remains controversial. Thorough evaluation on the extent of resection should be made to minimize post-surgery decline in quality of life.

摘要

腹膜后脂肪肉瘤是一种源自脂肪细胞的罕见恶性肿瘤。它们在引发临床症状之前可以长得很大。直径超过30厘米的巨大腹膜后脂肪肉瘤极为罕见。到目前为止,仅报道了13例直径大于30厘米的巨大腹膜后脂肪肉瘤。对于这些巨大肿瘤的治疗经验非常少。在此,我们报告一名65岁男性患者,诊断为巨大腹膜后脂肪肉瘤。该患者接受了成功的完整手术切除。肿瘤几乎占据了整个腹腔,大小为37.0厘米×32.0厘米×26.5厘米,重量为21.0千克。组织病理学分析显示为I级、高分化脂肪肉瘤。患者顺利出院,在12个月的随访中未观察到复发迹象。此外,我们在PubMed数据库中检索了13篇关于直径大于30厘米的腹膜后脂肪肉瘤的英文文献。分析表明,不应仅将肿瘤大小视为手术切除的禁忌证。如果确认有局部侵犯,则有必要联合切除相邻器官。辅助放疗或化疗的作用仍存在争议。应全面评估切除范围,以尽量减少术后生活质量的下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35c8/7607090/bb7406ef559e/atm-08-19-1248-f1.jpg

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