Hoshino Tatsuji, Takada Yoshihiro, Sugihara Ayako, Kinugasa Masato, Tsuji Yoshiyuki
Department of Obstetrics and Gynecology, Meiwa General Hospital, Nishinomiya, Japan.
Department of Radiology, Meiwa General Hospital, Nishinomiya, Japan.
Case Rep Obstet Gynecol. 2024 Feb 24;2024:7599714. doi: 10.1155/2024/7599714. eCollection 2024.
This study reports a case of uterine liposarcoma together with a literature review. At 52 years old, our patient was diagnosed with lipoleiomyoma by MRI. A mass (39 × 32 × 41 mm) protruding from the anterior wall of the uterine body was observed. When the patient was 58, her previous doctor found that the tumor had grown, and she was referred to the gynecology department of our hospital. On MRI, the major diameter was 1.23-fold longer and the volume was 1.85-fold higher compared with the prior imaging findings. Diffusion-weighted images revealed no significant anomalous signals. Thus, malignant tumors were included in the differential diagnosis. The patient consented to total abdominal hysterectomy and bilateral salpingo-oophorectomy. The mass on the anterior wall remained completely in the myometrium. No implantation was found in the abdominal cavity, and ascites was not detected. No bleeding or necrosis was observed on the cut surface. Histopathologically, differences in the sizes of adipocytes and stromal cells were identified. There were irregularities in the nuclear findings. The immunohistochemical findings were as follows: CDK4 (+), desmin (+), S100p (-), and Ki - 67 = 1%. Therefore, a diagnosis of well-differentiated liposarcoma was rendered. The lesion was localized in the uterus, and it was completely removed during surgery. Well-differentiated liposarcoma of uterine primary has no possibility of recurrence following complete resection, and thus, the patient underwent follow-up without additional treatment. No metastasis or recurrence has been observed for 10 months after surgery.
本研究报告了一例子宫脂肪肉瘤病例并进行文献复习。患者52岁时，MRI诊断为脂肪平滑肌瘤。观察到子宫体前壁有一突出肿物（39×32×41mm）。患者58岁时，其前一位医生发现肿瘤增大，遂转诊至我院妇科。MRI显示，与之前的影像检查结果相比，肿物最大径增长了1.23倍，体积增大了1.85倍。扩散加权成像未显示明显异常信号。因此，鉴别诊断中考虑了恶性肿瘤。患者同意行全腹子宫切除术及双侧输卵管卵巢切除术。前壁肿物完全位于肌层内。腹腔内未发现种植转移，未检测到腹水。切面未见出血或坏死。组织病理学检查发现脂肪细胞和基质细胞大小存在差异，核表现不规则。免疫组化结果如下：CDK4（+），结蛋白（+），S100p（-），Ki-67=1%。因此，诊断为高分化脂肪肉瘤。病变局限于子宫，手术中已完全切除。子宫原发性高分化脂肪肉瘤完全切除后无复发可能，因此，患者术后未接受额外治疗进行随访。术后10个月未观察到转移或复发。
