Usuga Daniela, Atri Elias, Alloush Ferial, Poppiti Robert, Bhandari Akshay
Medical Student, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Urology, Mount Sinai Medical Center, Miami Beach, USA.
Cureus. 2023 Aug 29;15(8):e44325. doi: 10.7759/cureus.44325. eCollection 2023 Aug.
Retroperitoneal masses present a diagnostic challenge due to their elusive origin and varied clinical manifestations. Among these masses, retroperitoneal liposarcomas, rare tumors of mesenchymal origin, often grow asymptomatically until compressing surrounding structures, necessitating accurate and early diagnosis. Renal angiomyolipomas (AMLs) have also been reported to mimic retroperitoneal liposarcomas on radiographic imaging, further complicating diagnostic processes. The presented case report describes a rare instance of a large well-differentiated liposarcoma that mimicked a renal angiomyolipoma on imaging in a 58-year-old male patient. The patient initially presented with worsening abdominal distension, early satiety, and left-sided flank pain for the past year. Radiographic imaging revealed a large mixed echogenic lesion measuring 22 x 13 cm in the left kidney with diffuse fat contribution, suspected to be a giant renal angiomyolipoma. The patient underwent selective arterial embolization by interventional radiology. Follow-up imaging eight months later showed an increase in the size of the mass, raising suspicion of a liposarcoma. Surgical resection of the mass and a radical left nephrectomy were performed, with final pathology confirming the diagnosis of a well-differentiated liposarcoma. This case highlights the importance of accurate diagnosis and the potential for liposarcomas to mimic other masses on imaging, despite their rarity.
腹膜后肿块因其起源隐匿和临床表现多样而带来诊断挑战。在这些肿块中，腹膜后脂肪肉瘤是一种罕见的间充质起源肿瘤，通常无症状生长，直到压迫周围结构，因此需要准确早期诊断。据报道，肾血管平滑肌脂肪瘤（AML）在影像学上也可模仿腹膜后脂肪肉瘤，使诊断过程更加复杂。本病例报告描述了一例罕见的大型高分化脂肪肉瘤病例，在一名58岁男性患者的影像学检查中模仿了肾血管平滑肌脂肪瘤。患者最初表现为过去一年中腹胀加重、早饱及左侧胁腹疼痛。影像学检查显示左肾有一个大小为22×13 cm的混合回声大病变，有弥漫性脂肪成分，怀疑为巨大肾血管平滑肌脂肪瘤。患者接受了介入放射学的选择性动脉栓塞术。八个月后的随访影像学检查显示肿块增大，怀疑为脂肪肉瘤。对肿块进行了手术切除并实施了根治性左肾切除术，最终病理证实为高分化脂肪肉瘤。本病例强调了准确诊断的重要性，以及尽管脂肪肉瘤罕见，但在影像学上有模仿其他肿块的可能性。
