Shirouzu Yoshiyuki, Kishimoto Yukiya, Muroya Daisuke, Kadoya Kazutaka, Ishikawa Hiroto, Okabe Masayuki, Akagi Yoshito
Dept. of Surgery, Munakata Suikokai General Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1801-1803.
A 54-year-old male patient with a chief complaint of right lower abdominal pain and nausea visited the reporting hospital. Abdominal computed tomography was performed, which showed findings of a membrane-covered internally heterogeneous solid mass associated with a 11×10 cm well-circumscribed calcification, as well as ileus in the right lower abdomen. Based on the imaging findings, it was diagnosed with liposarcoma, and surgery was performed for both diagnosis and treatment. The mass was located in the mesentery of the terminal ileitis and could be removed without gross residue. Histopathological examination showed altered fat cells and fibrous partition, most of which were lipoma, but well-differentiated liposarcoma could also not be ruled out. It was diagnosed with lipoma mixed with well-differentiated liposarcoma. In particular, lipoma and liposarcoma from the mesentery proper is extremely rare. We encountered a case of lipoma arising from the mesentery proper that had difficulty in differential diagnosis with well-differentiated liposarcoma and here in report it with the addition of some literature consideration.
一名54岁男性患者，以右下腹痛和恶心为主诉前来本院就诊。进行了腹部计算机断层扫描，结果显示有一个被膜覆盖、内部不均匀的实性肿块，伴有一个11×10 cm边界清晰的钙化灶，以及右下腹肠梗阻。根据影像学检查结果，诊断为脂肪肉瘤，并进行了手术以明确诊断和治疗。肿块位于回肠末端系膜，可完整切除。组织病理学检查显示脂肪细胞和纤维间隔改变，大部分为脂肪瘤，但也不能排除高分化脂肪肉瘤。诊断为脂肪瘤合并高分化脂肪肉瘤。特别是，起源于固有系膜的脂肪瘤和脂肪肉瘤极为罕见。我们遇到了一例起源于固有系膜的脂肪瘤，与高分化脂肪肉瘤鉴别困难，在此报告并结合一些文献进行讨论。
