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根治性保守手术治疗巨大腹膜后脂肪肉瘤:1例报告并文献复习

Giant retroperitoneal liposarcoma treated with radical conservative surgery: A case report and review of literature.

作者信息

Lieto Eva, Cardella Francesca, Erario Silvia, Del Sorbo Giovanni, Reginelli Alfonso, Galizia Gennaro, Urraro Fabrizio, Panarese Iacopo, Auricchio Annamaria

机构信息

Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy.

Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples 80138, Campania, Italy.

出版信息

World J Clin Cases. 2022 Jul 6;10(19):6636-6646. doi: 10.12998/wjcc.v10.i19.6636.

Abstract

BACKGROUND

Retroperitoneal liposarcoma (RLPS) is a rare malignant tumor of the connective tissue and usually grows to a large size, undetected. Diagnosis is currently based on collective findings from clinical examinations and computed tomography (CT) and magnetic resonance imaging, the latter of which show a fat density mass and possible surrounding organ involvement. Surgical resection is the main therapeutic strategy. The efficacy and safety of further therapeutic choices, such as chemotherapy and radiotherapy, are still controversial.

CASE SUMMARY

A 61-year-old man presented with complaint of a large left inguinal mass that had appeared suddenly, after a slight exertion. Ultrasonography revealed an omental inguinal hernia. During further clinical examination, an enormous palpable abdominal mass, continuing from the left inguinal location, was observed. CT revealed a giant RLPS, with remarkable mass effect and wide visceral dislocation. After multidisciplinary consultation, surgical intervention was performed. Subsequent neoadjuvant chemotherapy and radiotherapy were precluded by the mass' large size and retroperitoneal localization, features typically associated with non-response to these types of treatment. Instead, the patient underwent conservative treatment radical surgical excision. After 1 year, his clinical condition remained good, with no radiological signs of recurrence.

CONCLUSION

Conservative treatment surgery resulted in a successful outcome for a large RLPS.

摘要

背景

腹膜后脂肪肉瘤(RLPS)是一种罕见的结缔组织恶性肿瘤,通常生长到很大尺寸才被发现。目前的诊断基于临床检查以及计算机断层扫描(CT)和磁共振成像的综合结果,后者显示为脂肪密度肿块且可能累及周围器官。手术切除是主要的治疗策略。化疗和放疗等进一步治疗选择的疗效和安全性仍存在争议。

病例摘要

一名61岁男性因轻微用力后突然出现左侧腹股沟巨大肿块前来就诊。超声检查显示为网膜腹股沟疝。在进一步临床检查中,发现一个从左侧腹股沟部位延续的巨大可触及腹部肿块。CT显示为巨大的腹膜后脂肪肉瘤,具有明显的占位效应和广泛的内脏移位。经过多学科会诊后进行了手术干预。由于肿块尺寸大且位于腹膜后,这些特征通常与对这类治疗无反应相关,因此随后未进行新辅助化疗和放疗。相反,患者接受了保守治疗——根治性手术切除。1年后,他的临床状况良好,无复发的影像学迹象。

结论

对于巨大的腹膜后脂肪肉瘤,保守治疗——手术取得了成功的结果。

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