Wang Lan, Lin Tingting, Hai Yubin, Yu Kai, Bu Fan, Lu Ji, Wang Xiuli, Li Miao, Shi Xiaoju
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, China.
Department of Urology, The First Hospital of Jilin University, Changchun, China.
Front Surg. 2024 Nov 13;11:1452144. doi: 10.3389/fsurg.2024.1452144. eCollection 2024.
Liposarcoma (LPS) is a kind of malignancy of soft tissue usually found in the retroperitoneal, limb, or neck region, and some may be detected with delayed symptoms (pain or palpable mass), and less frequently occurs in organs of the digestive system. In contrast, Dedifferentiated liposarcoma (DDLPS) is a common histological subtype of LPS. The present study reported a case of dedifferentiated liposarcoma originating in the gallbladder. Differentiated liposarcoma originating from the gallbladder is rarely reported.
A 64-year-old female patient presented to our hospital with a painless abdominal mass. Abdominal computed tomography (CT) showed that the gallbladder had lost its normal shape, and a 9.1 cm × 7.1 cm × 12.1 cm mass was seen in the area of the gallbladder fossa and the right upper abdomen below it, which had an irregular morphology, inhomogeneous density, and nodular calcification, with marked inhomogeneous enhancement on enhancement scan. Preoperative tumor markers and liver function indicators were not abnormal. With suspicion of a giant malignant tumor of the gallbladder, she underwent a cholecystectomy combined with abdominal mass resection. After surgery, the tumor and gallbladder, were completely resected, and postoperative pathological results confirmed the diagnosis of dedifferentiated liposarcoma deriving from gallbladder. After surgery, the patient and his family refused to continue treatment. After 15 months follow-up, the patient remains asymptomatic and does not show any signs of recurrence. And she is now under continued follow - up.
Treatment of dedifferentiated liposarcoma is still at exploratory stage, and a lack of clinical evidence for this condition might hinder access to clinical trials and studies. Currently, the treatment of choice for dedifferentiated liposarcoma remains radical resection. In the available clinical studies, there are no robust data to support clinical use of neoadjuvant and adjuvant radiochemotherapy. As with other diseases, the use of radiotherapy and chemotherapy before and after surgery may be a potential future treatment.
脂肪肉瘤（LPS）是一种软组织恶性肿瘤，通常发生于腹膜后、肢体或颈部区域，部分患者可能出现症状延迟（疼痛或可触及肿块），较少发生于消化系统器官。相比之下，去分化脂肪肉瘤（DDLPS）是LPS常见的组织学亚型。本研究报告了1例起源于胆囊的去分化脂肪肉瘤。起源于胆囊的分化型脂肪肉瘤鲜有报道。
一名64岁女性患者因无痛性腹部肿块就诊于我院。腹部计算机断层扫描（CT）显示胆囊失去正常形态，在胆囊窝及其下方右上腹区域可见一个9.1 cm×7.1 cm×12.1 cm的肿块，形态不规则，密度不均匀，有结节状钙化，增强扫描显示明显不均匀强化。术前肿瘤标志物和肝功能指标均无异常。因怀疑胆囊巨大恶性肿瘤，患者接受了胆囊切除术联合腹部肿块切除术。术后，肿瘤和胆囊被完整切除，术后病理结果证实为起源于胆囊的去分化脂肪肉瘤。术后，患者及其家属拒绝继续治疗。随访15个月后，患者无症状，未出现任何复发迹象。目前她仍在继续接受随访。
去分化脂肪肉瘤的治疗仍处于探索阶段，缺乏针对该疾病的临床证据可能会阻碍临床试验和研究的开展。目前，去分化脂肪肉瘤的首选治疗方法仍是根治性切除。在现有的临床研究中，没有有力的数据支持新辅助和辅助放化疗的临床应用。与其他疾病一样，手术前后使用放疗和化疗可能是未来潜在的治疗方法。
