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食管脂肪肉瘤导致的进行性吞咽困难,是具有挑战性情况下的一个复杂问题。

Progressive dysphagia from an esophageal liposarcoma, a complex problem in a challenging setting.

作者信息

Endara Santiago A, Dávalos Gerardo A, Finke Ana G, Ayala Veronica, Montalvo Nelson A, Munoz-Palomeque Santiago, Molina Gabriel A

机构信息

Department of Surgery Division of Cardiothoracic Surgery, Hospital Metropolitano, Quito 170521, Ecuador.

Department of Internal Medicine, Hospital Metropolitano, Quito 170521, Ecuador.

出版信息

J Surg Case Rep. 2024 Oct 29;2024(10):rjae670. doi: 10.1093/jscr/rjae670. eCollection 2024 Oct.

Abstract

Esophageal lipomatous tumors are extremely rare, and due to their nonspecific clinical manifestations, distinguishing them is nearly impossible without the aid of histopathology, immunohistochemistry, and molecular analysis. Complete resection with clear margins is the treatment of choice to avert metastasis, improve prognosis, and prevent complex complications due to the polyp growth and location. We present the case of a 70-year-old male who presented in 2023 with dysphagia due to an esophageal polyp; surgery was recommended. However, he did not accept any treatment due to fear. One year later, and since his symptoms worsened, he finally decided to undergo endoscopic treatment at another medical institution. However, during that procedure, he suffered severe asphyxia, which caused a cardiopulmonary arrest. Once he partially recovered and because he continued with dysphagia, surgery was completed, and the polyp was removed. The final diagnosis was esophageal liposarcoma.

摘要

食管脂肪瘤性肿瘤极为罕见,由于其临床表现不具特异性,若不借助组织病理学、免疫组织化学及分子分析,几乎无法将其鉴别出来。完整切除且切缘清晰是首选治疗方法,以避免转移、改善预后,并预防因息肉生长和位置导致的复杂并发症。我们报告一例70岁男性病例,该患者于2023年因食管息肉出现吞咽困难;建议进行手术。然而,由于恐惧,他未接受任何治疗。一年后,因症状加重,他最终决定在另一家医疗机构接受内镜治疗。然而,在该治疗过程中,他发生严重窒息,导致心跳骤停。待其部分恢复后,由于仍持续存在吞咽困难,遂完成手术并切除息肉。最终诊断为食管脂肪肉瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb56/11520925/298e8771006d/rjae670f1.jpg

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