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一例经三维CT血管造影确诊的源于胰周脂肪组织的巨大脂肪肉瘤:病例报告

A giant liposarcoma originating from peripancreatic fat tissue with identification using 3D-CT angiography: a case report.

作者信息

Narita Kiyoshi, Kaneko Hiroshi, Hasegawa Fumiya, Akao Nozomi, Kusafuka Tomoki, Desaki Ryosuke, Ogura Masaomi, Hamada Takashi, Asakawa Kana, Murata Tetsuya

机构信息

Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan.

Department of Pathology, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan.

出版信息

Surg Case Rep. 2024 Jan 8;10(1):7. doi: 10.1186/s40792-023-01797-3.

Abstract

BACKGROUND

Liposarcoma originating from peripancreatic fat tissue is extremely rare. This case report presents a surgical case of a giant liposarcoma originating from peripancreatic fat tissue with origin identification using 3-Dimensional Computed Tomography Angiography (3D-CTA).

CASE PRESENTATION

A 59-year-old female was referred to our hospital with a giant abdominal tumor. Computed tomography revealed a 34 cm tumor composed of fatty tissue, exerting pressure on the posterior aspect of the pancreas. Suspecting liposarcoma, we planned for surgery. At first, the tumor appeared to be intra-abdominal tumor, based on the identification of the tumor's feeding artery as a branch of the dorsal pancreatic artery using 3D-CTA, we concluded that the liposarcoma originated from the peripancreatic fat tissue and situated in the retroperitoneum. During surgery, we observed a well-capsulated, elastic, yellowish mass without infiltration into surrounding tissues. We carefully dissected the tumor from the greater omentum and transverse mesocolon while preserving the tumor capsule. We ligated the feeding artery at the border with the pancreatic parenchyma and successfully completed the excision of the tumor. The resected specimen weighted 2620 g and was pathologically diagnosed as a well-differentiated liposarcoma. There was no injury to the tumor's capsule, and the surgical margins were negative.

CONCLUSIONS

In this report, we present an extremely rare case of a liposarcoma originating in the peripancreatic fat tissue. The use of 3D-CTA was instrumental in identifying the primary site of this giant tumor, enabling us to guide the surgery and achieve complete resection successfully.

摘要

背景

起源于胰腺周围脂肪组织的脂肪肉瘤极为罕见。本病例报告介绍了一例起源于胰腺周围脂肪组织的巨大脂肪肉瘤的手术病例,并使用三维计算机断层血管造影(3D-CTA)进行了起源鉴定。

病例介绍

一名59岁女性因腹部巨大肿瘤被转诊至我院。计算机断层扫描显示一个34厘米的肿瘤,由脂肪组织构成,对胰腺后方施加压力。怀疑为脂肪肉瘤,我们计划进行手术。起初,肿瘤似乎是腹腔内肿瘤,基于使用3D-CTA将肿瘤的供血动脉鉴定为胰背动脉的一个分支,我们得出结论,该脂肪肉瘤起源于胰腺周围脂肪组织并位于腹膜后。手术过程中,我们观察到一个包膜完整、有弹性、淡黄色的肿块,未浸润周围组织。我们小心地从大网膜和横结肠系膜上分离肿瘤,同时保留肿瘤包膜。我们在与胰腺实质的边界处结扎了供血动脉,并成功完成了肿瘤切除。切除标本重2620克,病理诊断为高分化脂肪肉瘤。肿瘤包膜无损伤,手术切缘阴性。

结论

在本报告中,我们介绍了一例起源于胰腺周围脂肪组织的极为罕见的脂肪肉瘤病例。3D-CTA的使用有助于确定这个巨大肿瘤的原发部位,使我们能够指导手术并成功实现完整切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f256/10772136/3f064aef2b37/40792_2023_1797_Fig2_HTML.jpg

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