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黏液样脂肪肉瘤转移至下颌骨:首例病例报告及文献复习

Myxoid liposarcoma metastatic to the mandible: First case report and review of the literature.

作者信息

Oh Kyu-Young, Hong Seong-Doo

机构信息

Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Republic of Korea; Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.

出版信息

Oral Oncol. 2022 Jun;129:105900. doi: 10.1016/j.oraloncology.2022.105900. Epub 2022 May 4.

Abstract

Unlike other soft tissue sarcomas, myxoid liposarcoma tends to metastasize to bone even before developing lung metastases. In this report, we present a unique case of myxoid liposarcoma metastatic to the mandible. A 40-year-old male who had a history of myxoid liposarcoma in the buttock presented with paresthesia in the left lower face and mandible. Radiographic examination revealed an ill-defined radiolucent lesion with cortical destruction in the left mandibular body and ramus. Histopathological examination showed a mixture of small lipoblasts and round primitive mesenchymal cells in a myxoid stroma. Hypercellular areas comprising high-grade round cells were frequently found. The final diagnosis of metastatic myxoid liposarcoma was made. Despite postoperative chemoradiotherapy, further metastases occurred in the lungs and liver, and the patient died of the tumor 23 months after the treatment of the mandibular lesion. This is the first report of myxoid liposarcoma metastatic to the jaw, which may help in the differential diagnosis of intraosseous myxoid tumors of the jaws and highlights unfavorable clinical outcome of metastatic high-grade myxoid liposarcoma.

摘要

与其他软组织肉瘤不同,黏液样脂肪肉瘤甚至在发生肺转移之前就倾向于转移至骨。在本报告中,我们呈现了一例转移至下颌骨的黏液样脂肪肉瘤的独特病例。一名40岁男性,有臀部黏液样脂肪肉瘤病史,出现左下颌面部及下颌骨感觉异常。影像学检查显示左下颌骨体部及升支有边界不清的透射性病变,伴有皮质破坏。组织病理学检查显示在黏液样基质中有小的脂肪母细胞和圆形原始间充质细胞混合存在。经常发现由高级别圆形细胞组成的高细胞区。最终诊断为转移性黏液样脂肪肉瘤。尽管术后进行了放化疗,但肺部和肝脏仍出现了进一步转移,患者在治疗下颌骨病变23个月后死于肿瘤。这是首例关于转移至颌骨的黏液样脂肪肉瘤的报告,这可能有助于颌骨骨内黏液样肿瘤的鉴别诊断,并突出了转移性高级别黏液样脂肪肉瘤不良的临床结局。

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