Harada Suzuka, Ueda Takeshi, Tanaka Tetsuya, Yokoyama Takashi, Yoshimura Atsushi
Dept. of Surgery, Minami Nara General Medical Center.
Gan To Kagaku Ryoho. 2021 Apr;48(4):605-607.
A man in his 70s was referred to our hospital for the examination of an abdominal tumor detected incidentally. The tumor was resected with a preoperative diagnosis of gastric submucosal tumor. As a result of the histopathological examination, dedifferentiated liposarcoma was diagnosed. The tumor recurred 2 months after the operation, and resection was attempted again. However, the intraoperative findings showed multiple metastatic lesions, and radical resection was considered impossible. Chemotherapy was therefore administered with doxorubicin monotherapy and eribulin, but the tumor rapidly increased, and the patient ultimately died 8 months after the initial operation. Dedifferentiated liposarcoma is a histologic type with a poor prognosis among liposarcoma. Resection is the standard treatment, but it frequently develops in the retroperitoneum, and it is often found in an advanced state due to the lack of subjective symptoms compared to lesions of the extremities. In addition, its tendency to infiltrate into the surrounding area and to metastasize are also factors that make radical resection difficult. We herein report a case of dedifferentiated liposarcoma that was detected asymptomatically but had a rapid outcome.
一名70多岁的男性因偶然发现腹部肿瘤而被转诊至我院。该肿瘤在术前诊断为胃黏膜下肿瘤后被切除。组织病理学检查结果显示为去分化脂肪肉瘤。肿瘤在术后2个月复发，再次尝试切除。然而，术中发现多处转移灶，认为无法进行根治性切除。因此给予多柔比星单药化疗和艾瑞布林治疗，但肿瘤迅速增大，患者最终在初次手术后8个月死亡。去分化脂肪肉瘤是脂肪肉瘤中预后较差的一种组织学类型。手术切除是标准治疗方法，但它常发生于腹膜后，且由于与肢体病变相比缺乏主观症状，常发现时已处于晚期。此外，其向周围浸润和转移的倾向也是导致根治性切除困难的因素。我们在此报告一例无症状发现但预后迅速恶化的去分化脂肪肉瘤病例。
