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巨大股部肌内脂肪瘤:一例报告并文献复习

Giant intramuscular thigh lipoma: A case report and review of literature.

作者信息

Morales Morales Carlos Antonio, González Urquijo Mauricio, Morales Flores Luis Fernando, Sánchez Gallegos Max Net, Rodarte Shade Mario

机构信息

Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Dr. Ignacio Morones Prieto O 3000, Monterrey, 64710, Mexico.

Universidad de Monterrey, Dr. Ignacio Morones Prieto 4500, Zona Valle Poniente, San Pedro Garza García, 66238, Mexico.

出版信息

Int J Surg Case Rep. 2021 May;82:105885. doi: 10.1016/j.ijscr.2021.105885. Epub 2021 Apr 14.

Abstract

INTRODUCTION

Lipomas are the most common soft tissue tumor. Giant lipomas are defined by measuring at least 10 cm in diameter in one dimension or by a minimum of 1000 g. They often are asymptomatic; however, they can cause compression syndromes due to nerve damage and difficulties in walking.

PRESENTATION OF CASE

We described the case of a 25-year-old female with no significant medical history who began her condition two years before her consultation. The patient referred to the appearance of a non-painful mass on her right thigh with progressive growth that hinders daily activities. A simple CT scan reported a 10.3 × 8.1 × 19.6 cm adipose mass with infiltration towards the semitendinosus muscle and the biceps femoris muscle. A free margin resection of the tumor was performed, and the involved muscles were preserved. The patient had a satisfactory postoperative outcome.

DISCUSSION

Lipomas are common benign soft tissue tumors that arise from fatty tissue and may challenge surgical management due to their extension and dimensions; they often require delicate surgical intervention due to their potential risk of malignant transformation. We believe surgical pathologists and radiologists must draw attention to muscle involvement and the infiltrative pattern.

CONCLUSION

Giant lipomas should always raise awareness of malignant transformation. Radiological guidance should provide enough evidence to decide whether to do a biopsy or not; hence, saving the patient an extra invasive procedure. We recommend taking at least 1 cm of border margin while removing these tumors to avoid local recurrence.

摘要

引言

脂肪瘤是最常见的软组织肿瘤。巨大脂肪瘤的定义是在一个维度上直径至少为10厘米或重量至少为1000克。它们通常无症状;然而,由于神经损伤和行走困难,它们可导致压迫综合征。

病例介绍

我们描述了一名25岁女性的病例,她没有重大病史,在就诊前两年开始出现这种情况。患者提到右大腿出现一个无痛性肿块,逐渐增大,妨碍日常活动。一项简单的CT扫描报告显示一个10.3×8.1×19.6厘米的脂肪肿块,向半腱肌和股二头肌浸润。对肿瘤进行了游离边缘切除术,并保留了受累肌肉。患者术后结果令人满意。

讨论

脂肪瘤是常见的良性软组织肿瘤,起源于脂肪组织,由于其范围和大小,可能对手术治疗构成挑战;由于其潜在的恶性转化风险,它们通常需要精细的手术干预。我们认为手术病理学家和放射科医生必须关注肌肉受累情况和浸润模式。

结论

巨大脂肪瘤应始终提高对恶性转化的认识。放射学指导应提供足够的证据来决定是否进行活检;从而为患者省去额外的侵入性操作。我们建议在切除这些肿瘤时至少留出1厘米的边缘,以避免局部复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdb1/8091888/3dcbcce75f18/gr1.jpg

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