Mashima Emi, Sawada Yu, Saito-Sasaki Natsuko, Yamamoto Kayo, Ohmori Shun, Omoto Daisuke, Yoshioka Haruna, Yoshioka Manabu, Okada Etsuko, Aoki Takatoshi, Hisaoka Masanori, Nakamura Motonobu
Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Front Med (Lausanne). 2020 Dec 17;7:609515. doi: 10.3389/fmed.2020.609515. eCollection 2020.
Atypical lipomatous tumor (ALT) has been defined as a well-differentiated liposarcoma exhibiting a higher frequency of a local recurrence after surgical resection. ALT is mainly classified into deep type and superficial type. Compared with deep type ALT, superficial type ALT is rarely observed. One of the most important issues is that little has been known about superficial type ALT and it is not easy to predict the presence of superficial type ALT before surgical resection. To clarify the clinical manifestations of superficial type ALT, we examined 15 cases with superficial type ALT and 118 cases with benign lipoma, and analyzed their differences in clinical characteristics and the findings of MRI test. In clinical characteristics, the tumor size of superficial type ALT was significantly greater than that of benign lipoma, and superficial type ALT showed a significantly higher frequency of the tumor size of more than 4 cm. Superficial type ALT exhibited poor tumor mobility and hardness with elastic soft. In addition, a significantly higher frequency of tumor location of superficial type ALT was observed in extremities. Among tumor sites at the trunk, buttocks, and shoulder were high frequent location in superficial type ALT. In an MRI examination, superficial type ALT exhibited a significantly higher frequency of the septal structures compared with benign lipoma. The combinations of clinical characteristics, including physical examinations, MRI, and histological examinations, are helpful for the diagnosis of superficial type ALT.
非典型脂肪瘤性肿瘤（ALT）被定义为一种高分化脂肪肉瘤，手术切除后局部复发频率较高。ALT主要分为深部型和浅表型。与深部型ALT相比，浅表型ALT较少见。最重要的问题之一是，人们对浅表型ALT知之甚少，在手术切除前很难预测浅表型ALT的存在。为了阐明浅表型ALT的临床表现，我们检查了15例浅表型ALT患者和118例良性脂肪瘤患者，并分析了它们在临床特征和MRI检查结果上的差异。在临床特征方面，浅表型ALT的肿瘤大小明显大于良性脂肪瘤，且浅表型ALT肿瘤大小超过4cm的频率明显更高。浅表型ALT肿瘤活动度差，质地硬且有弹性。此外，浅表型ALT在四肢的肿瘤位置频率明显更高。在躯干的肿瘤部位中，臀部和肩部是浅表型ALT的高频部位。在MRI检查中，浅表型ALT与良性脂肪瘤相比，间隔结构的频率明显更高。包括体格检查、MRI和组织学检查在内的临床特征组合有助于浅表型ALT的诊断。
