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复发性睾丸旁巨大脂肪肉瘤:病例报告及文献复习

Recurrent paratesticular giant liposarcoma: A case report and literature review.

作者信息

Hua Runmiao, Zhao Liwei, Xu Li, Sun Ji, Huang Jiaguo, Hua Qiyan

机构信息

Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China.

Department of Urology, School of Medicine, Hangzhou Normal University, Hangzhou, China.

出版信息

Front Surg. 2023 Apr 27;10:1171952. doi: 10.3389/fsurg.2023.1171952. eCollection 2023.

Abstract

BACKGROUND

Primary paratesticular liposarcoma is rarely diagnosed among urinary tumors. In this study, through the retrospective analysis of clinical data and literature review, a case of recurrent paratesticular liposarcoma with lymph node metastasis after radical resection has been reported to explore novel strategies for the diagnosis, treatment and prognosis of this rare disease.

CASE SUMMARY

The present case involved a patient who was misdiagnosed as a left inguinal hernia for the first time two years ago, but was later diagnosed as mixed liposarcoma by using postoperative pathology. Currently, he is readmitted to the hospital with a recurrence of the left scrotal mass for more than 1 year. Combined with the patient's past medical history, we performed radical resection of the left inguinal and scrotal tumors and lymphadenectomy of left femoral vein. The postoperative pathology indicated that well-differentiated liposarcoma was accompanied by mucinous liposarcoma (about 20%), and lymph node metastasis of left femoral vein both of which occurred at the same time. After the operation, we recommended the patient to receive further radiation therapy, but the patient and his family refused, hence we followed up the patient closely for a long time. During the recent follow-up, the patient reported no complaints of discomfort, and no recurrence of mass in the left scrotum and groin area.

CONCLUSION

After conducting extensive review of literature, we conclude that radical resection remains the key to treat primary paratesticular liposarcoma, while the significance of the lymph node metastasis is still unclear. The potential effects of postoperative adjuvant therapy depends on the pathological type, and hence close follow-up observation is essential.

摘要

背景

原发性睾丸旁脂肪肉瘤在泌尿肿瘤中很少被诊断出来。在本研究中,通过对临床资料的回顾性分析和文献复习,报告了1例根治性切除术后复发并伴有淋巴结转移的睾丸旁脂肪肉瘤病例,以探索这种罕见疾病的诊断、治疗及预后的新策略。

病例摘要

该病例患者两年前首次被误诊为左侧腹股沟疝,术后病理诊断为混合型脂肪肉瘤。目前,因左侧阴囊肿物复发1年余再次入院。结合患者既往病史,我们对其实施了左侧腹股沟及阴囊肿瘤根治性切除术及左股静脉淋巴结清扫术。术后病理显示为高分化脂肪肉瘤伴黏液性脂肪肉瘤(约20%),且同时发生左股静脉淋巴结转移。术后,我们建议患者接受进一步放疗,但患者及其家属拒绝,因此我们对患者进行了长期密切随访。在最近一次随访中,患者表示无不适主诉,左侧阴囊及腹股沟区未再出现肿物复发。

结论

在广泛查阅文献后,我们得出结论,根治性切除仍然是治疗原发性睾丸旁脂肪肉瘤的关键,而淋巴结转移的意义仍不明确。术后辅助治疗的潜在效果取决于病理类型,因此密切随访观察至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2135/10172677/9688072d9ad9/fsurg-10-1171952-g001.jpg

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