Ayoub Madani, Leila Bouzayan, Yassin Mabrouk, Achraf Miry, Rachid Jabi, Mohamed Pr Bouziane
Department of Visceral Surgery and Digestive Oncology A, Mohammed VI University Hospital.
Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco.
Ann Med Surg (Lond). 2023 Apr 12;85(5):2130-2134. doi: 10.1097/MS9.0000000000000592. eCollection 2023 May.
Liposarcoma is a rare, primary, malignant mesenchymal tumor. It represents ∼7% of all mesenchymal sarcomas and 1% of all cancers. Their incidence does not exceed to 2.5 cases/million inhabitants/year. This tumor is locally invasive, diagnosed at a late stage, and can reach a significant size and weight, resulting in a locally advanced tumor.
A 59-year-old female patient consulting for a large abdominal mass. The abdominal computed tomography showed three retroperitoneal masses, and the surgical exploration revealed a huge process in the retroperitoneal cavity, which takes the left renal compartment, and the left colon. The intervention consisted of a mono-bloc excision of the mass taking the spleen, the left renal compartment, and the left colon with colonic anastomosis. The histological examination concluded the existence of a well-differentiated myxoid liposarcoma of grade I, the postoperative follow-up was simple. One year later, she underwent an excision of a recurrence of the same retroperitoneal location, but of a pleomorphic cell histological type of grade II according to the FNCLCC classification. We review the literature, the pathological, therapeutic, and prognostic aspects of this tumor.
Retroperitoneal liposarcoma is a rare tumor. Its gravity is due to an often-late diagnosis, a complete imaging workup including ultrasound, computed tomography and often MRI is necessary preoperatively to determine the relationship with the different organs. The definitive diagnosis is histological, surgery is the most effective treatment and can be extended to neighboring organs. the frequency of recurrence requires particular surveillance.
We highlight the importance of radical surgical excision to avoid retroperitoneal liposarcoma tumor complications and to minimize the recurrence risk.
脂肪肉瘤是一种罕见的原发性恶性间充质肿瘤。它约占所有间充质肉瘤的7%,占所有癌症的1%。其发病率不超过每百万居民每年2.5例。这种肿瘤具有局部侵袭性,诊断时往往已处于晚期,可长得很大且很重,导致局部进展期肿瘤。
一名59岁女性患者因腹部有巨大肿块前来就诊。腹部计算机断层扫描显示有三个腹膜后肿块,手术探查发现腹膜后腔有一个巨大肿物,占据左肾区和左结肠。手术干预包括整块切除肿物,切除范围包括脾脏、左肾区和左结肠,并进行结肠吻合术。组织学检查结果为I级高分化黏液样脂肪肉瘤,术后随访情况简单。一年后,她再次接受手术,切除同一腹膜后部位复发的肿瘤,但根据法国癌症中心联合会(FNCLCC)分类,此次肿瘤为II级多形性细胞组织学类型。我们回顾了该肿瘤的文献、病理、治疗及预后方面的情况。
腹膜后脂肪肉瘤是一种罕见肿瘤。其严重性在于诊断往往较晚,术前需要进行包括超声、计算机断层扫描且常常还需磁共振成像(MRI)的全面影像学检查,以确定与不同器官的关系。明确诊断依靠组织学检查,手术是最有效的治疗方法,且可扩大至邻近器官。复发频率需要特别监测。
我们强调根治性手术切除对于避免腹膜后脂肪肉瘤肿瘤并发症及降低复发风险的重要性。