Jivani Ashish, Shinde Raju K, Jajoo Bhushan
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Surgical Oncology, SGM cancer hospital, Wardha, IND.
Cureus. 2024 Aug 23;16(8):e67643. doi: 10.7759/cureus.67643. eCollection 2024 Aug.
This case report presents the rare occurrence of a large dedifferentiated liposarcoma originating from the abdominal wall in a 57-year-old male. The patient's initial complaint was the gradual development of an abdominal mass over six months without associated urinary or digestive symptoms. Clinical examination revealed a firm, non-mobile mass in the left lumbar region, prompting further investigation. Imaging studies confirmed the presence of a sizable soft tissue mass with calcifications, suggestive of a sarcoma. Preoperative biopsy indicated a malignant mesenchymal tumor, leading to surgical intervention. Intraoperative findings revealed characteristics consistent with a low-grade malignancy, prompting complete tumor resection with flap reconstruction. Subsequent histopathological analysis confirmed the diagnosis of dedifferentiated liposarcoma with negative surgical margins. The patient was referred for palliative chemotherapy due to the aggressive nature of the tumor. This case underscores the diagnostic challenges and therapeutic considerations associated with rare abdominal wall liposarcomas, emphasizing the importance of a multidisciplinary approach in their management.
本病例报告展示了一名57岁男性罕见地发生了起源于腹壁的巨大去分化脂肪肉瘤。患者最初的主诉是在六个月内腹部肿块逐渐增大,且无相关泌尿系统或消化系统症状。临床检查发现左腰区有一个质地坚硬、活动度差的肿块,遂进行进一步检查。影像学研究证实存在一个伴有钙化的较大软组织肿块,提示为肉瘤。术前活检显示为恶性间叶性肿瘤,从而进行了手术干预。术中发现具有与低级别恶性肿瘤相符的特征,于是进行了肿瘤完整切除并采用皮瓣重建。随后的组织病理学分析证实为去分化脂肪肉瘤,手术切缘阴性。由于肿瘤具有侵袭性,患者被转诊接受姑息性化疗。本病例强调了与罕见的腹壁脂肪肉瘤相关的诊断挑战和治疗考量,凸显了多学科方法在其管理中的重要性。