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一名41岁患者的巨大黏液性腹膜后脂肪肉瘤:病例报告

Giant myxoid retroperitoneal liposarcoma in a 41-year-old patient: A case report.

作者信息

Díaz de León-Romero César Eduardo, Jiménez-Yarza Miguel, Pérez-Tristán Carlos Eduardo, Jiménez-Yarza Luis Ernesto, Valdes-Ramos Rodolfo Lucano, Ortiz-Cisneros José Daniel

机构信息

Hospital Regional Monterrey - Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Department of General Surgery, Mexico.

Hospital Regional Monterrey - Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Department of General Surgery, Mexico.

出版信息

Int J Surg Case Rep. 2023 Aug;109:108572. doi: 10.1016/j.ijscr.2023.108572. Epub 2023 Jul 28.

Abstract

INTRODUCTION

Retroperitoneal Liposarcomas (RL) are a rare form of malignant tumors, they encompass just 5 % ot these and mainly present in female adults between 50 and 60 years of age. They can be divided into 4 morphological subtypes: 1) well-differentiated, 2) undifferentiated, 3) myxoid, and 4) pleomorphic.

CASE PRESENTATION

41-year-old male who present to the outpatient consult of oncological surgery after being diagnosed via imaging with a giant retroperitoneal liposarcoma. The patient reported unsuccessful weight loss attempts and subsequently noticed an increase in abdominal size as well as the development of ulcers in the lower limbs. He underwent radical resection, which included a right nephrectomy, as the primary treatment.

DISCUSSION

Giant retroperitoneal liposarcomas are defined as those 30 cm in diameter or more or 20 kg or more in weight are considered "giants" and are extremely rare. The only treatment involves resection of the tumoration and those adjacent involved organs, and sometimes, uninvolved ones. Due to the high risk of recurrence, adjuvant therapy may be provided as well as imaging follow up.

CONCLUSION

RL are a complicated entity to manage. They tend to present high rates of recurrence due to the difficulty of performing a full resection without positive margins. These patients should be thoroughly studied before surgery and appropriate follow-up should be provided.

摘要

引言

腹膜后脂肪肉瘤(RL)是一种罕见的恶性肿瘤形式,仅占所有此类肿瘤的5%,主要发生于50至60岁的成年女性。它们可分为4种形态学亚型:1)高分化型,2)未分化型,3)黏液型,4)多形型。

病例介绍

一名41岁男性,经影像学诊断为巨大腹膜后脂肪肉瘤后到肿瘤外科门诊就诊。患者报告减肥尝试未成功,随后注意到腹部增大以及下肢出现溃疡。他接受了根治性切除术,包括右肾切除术,作为主要治疗方法。

讨论

巨大腹膜后脂肪肉瘤被定义为直径30厘米或更大或重量20千克或更重的肿瘤被视为“巨大”,且极为罕见。唯一的治疗方法是切除肿瘤及相邻受累器官,有时还包括未受累的器官。由于复发风险高,可能需要进行辅助治疗以及影像学随访。

结论

腹膜后脂肪肉瘤是一种难以处理的疾病。由于难以实现切缘阴性的完整切除,它们往往具有较高的复发率。这些患者在手术前应进行全面评估,并应提供适当的随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a983/10400856/3f9057bc61c3/gr1.jpg

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