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巨大腹膜后脂肪瘤伴腹胀:一例报告并文献复习

Giant retroperitoneal lipoma presenting with abdominal distention: A case report and review of the literature.

作者信息

Chen Zhi-Yan, Chen Xian-Long, Yu Qi, Fan Qing-Bo

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China.

Department of Pathology, Peking Union Medical College Hospital, Beijing 100730, China.

出版信息

World J Clin Cases. 2022 Feb 16;10(5):1675-1683. doi: 10.12998/wjcc.v10.i5.1675.

Abstract

BACKGROUND

Retroperitoneal lipomas are extremely rare tumors and tend to be large in size (> 10 cm) when diagnosed, causing various clinical manifestations. Preoperative diagnosis of retroperitoneal lipomas is difficult. There is a lack of relevant information about the management and prognosis of these benign tumors due to limited reports.

CASE SUMMARY

A 53-year-old woman who complained about progressive abdominal distention and aggravating satiety was referred to the gynecological outpatient department of Peking Union Medical College Hospital. Computerized tomography (CT) revealed an immense mass with fat density, measuring 28.6 cm× 16.6 cm in size. Adjacent organs, including the intestinal tract and uterus, were squeezed to the right side of the abdomen. An exploratory laparotomy was performed with suspicion of liposarcoma. Intraoperatively, a giant yellowish lobulated mass was found occupying the retroperitoneum and it was removed by tumor debulking. Postoperative histopathological results confirmed the diagnosis of retroperitoneal lipoma.

CONCLUSION

Retroperitoneal lipoma is a very rare condition and is difficult to differentiate from well-differentiated liposarcoma. Radiographic investigations, especially CT and magnetic resonance imaging, are important for preoperative diagnosis. Surgical resection is the fundamental treatment, which is difficult due to its size and relation to neighboring structures.

摘要

背景

腹膜后脂肪瘤是极其罕见的肿瘤,诊断时往往体积较大(>10 cm),可引起各种临床表现。腹膜后脂肪瘤的术前诊断困难。由于报道有限,关于这些良性肿瘤的治疗和预后缺乏相关信息。

病例摘要

一名53岁女性因进行性腹胀和饱腹感加重就诊于北京协和医院妇科门诊。计算机断层扫描(CT)显示一个巨大的脂肪密度肿块,大小为28.6 cm×16.6 cm。包括肠道和子宫在内的相邻器官被挤压到腹部右侧。因怀疑脂肪肉瘤而行剖腹探查术。术中发现一个巨大的淡黄色分叶状肿块占据腹膜后间隙,通过肿瘤减积术将其切除。术后组织病理学结果确诊为腹膜后脂肪瘤。

结论

腹膜后脂肪瘤是一种非常罕见的疾病,难以与高分化脂肪肉瘤相鉴别。影像学检查,尤其是CT和磁共振成像,对术前诊断很重要。手术切除是根本的治疗方法,但因其大小和与邻近结构的关系,手术难度较大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a986/8855279/9b1dce43195b/WJCC-10-1675-g001.jpg

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