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巨大腹膜后脂肪肉瘤病例报告

A case report of giant retroperitoneal liposarcoma.

作者信息

Bao Zicheng, Jia Nan, Zhang Zhidong, Ding Pingan, Zhao Qun, Zhao Xuefeng, Li Yong

机构信息

Third Department of Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41923. doi: 10.1097/MD.0000000000041923.

Abstract

RATIONALE

Retroperitoneal liposarcoma (RPLS) is a rare malignancy with a high recurrence rate. Giant RPLS (≥30 cm) poses significant surgical challenges due to its invasive nature and compression of vital organs. Early diagnosis and multidisciplinary management are critical yet underreported in young patients. This case highlights the complexity of managing a 36-year-old male with a 60 cm × 50 cm × 40 cm tumor, emphasizing the importance of surgical precision and collaborative care.

PATIENT CONCERNS

The patient is a 36-year-old male who was admitted to the hospital due to abdominal distension presenting for over 7 months, accompanied by a rapid increase in abdominal girth for over the past 2 months. Based on his symptoms, physical examination findings, and imaging studies, the possibility of a giant retroperitoneal liposarcoma was considered.

DIAGNOSES

Giant retroperitoneal liposarcoma.

INTERVENTIONS

The treatment involved the resection of the massive retroperitoneal tumor, along with partial resection of the descending colon, left ureterostomy drainage, and release of intestinal adhesions.

OUTCOMES

The patient was discharged 14 days postoperatively with no immediate complications. Albumin levels improved to 35.2 g/L at 1-month follow-up. Telephone follow-ups at 3, 6, 12 months, and 5 years revealed no signs of recurrence on abdominal ultrasound.

LESSONS

The tumor had already invaded the surrounding organ tissues at the time of discovery in this case. Comprehensive preoperative evaluation, multidisciplinary collaboration in diagnosis and treatment, precise surgical techniques, and standardized intraoperative and postoperative management are essential to enhance surgical resection rates, minimize complications, and decrease the likelihood of postoperative recurrence.

摘要

原理

腹膜后脂肪肉瘤(RPLS)是一种罕见的恶性肿瘤,复发率高。巨大腹膜后脂肪肉瘤(≥30厘米)因其侵袭性和对重要器官的压迫而带来重大手术挑战。早期诊断和多学科管理至关重要,但在年轻患者中报道较少。本病例突出了一名36岁男性患者,其肿瘤大小为60厘米×50厘米×40厘米,治疗管理的复杂性,强调了手术精准度和协作护理的重要性。

患者关注

该患者为36岁男性,因腹胀7个多月入院,过去2个月腹围迅速增加。根据其症状、体格检查结果和影像学检查,考虑为巨大腹膜后脂肪肉瘤的可能性。

诊断

巨大腹膜后脂肪肉瘤。

干预措施

治疗包括切除巨大的腹膜后肿瘤,同时部分切除降结肠、左输尿管造瘘引流和松解肠粘连。

结果

患者术后14天出院,无近期并发症。1个月随访时白蛋白水平提高到35.2克/升。在3个月、6个月、12个月和5年的电话随访中,腹部超声未发现复发迹象。

经验教训

本病例中肿瘤在发现时已侵犯周围器官组织。全面的术前评估、诊断和治疗中的多学科协作、精确的手术技术以及标准化的术中及术后管理对于提高手术切除率、减少并发症和降低术后复发可能性至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2392/11936651/aa2e00902b94/medi-104-e41923-g001.jpg

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