Wang Meng, Sun Jian, Song Zhi-Qiang, Chen Xi-Qi, Xie Guang-Dong, Zhu Yong, Zhou Yong-Kun
Department of General Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China.
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China.
World J Gastrointest Surg. 2025 Jun 27;17(6):107866. doi: 10.4240/wjgs.v17.i6.107866.
Liposarcomas (LPSs) are malignant mesenchymal tumors originating from adipocytes. Myxoid LPS (MLPS), a common subtype, predominantly arises in the extremities, retroperitoneum, and deep soft tissues, with a rare occurrence in the gastrointestinal tract. Primary mesenteric LPS is particularly uncommon, especially in the transverse colonic mesentery.
This report describes the case of a 65-year-old female patient who presented with abdominal distension and was diagnosed with a giant mucinous LPS of the transverse colonic mesentery. Upon admission, the patient underwent a comprehensive evaluation. Contrast-enhanced computed tomography (CT) of the chest and abdomen revealed a large malignant tumor with aortic dissection, while colonoscopy identified rectal cancer. Given the patient's condition and surgical risk, an interventional procedure was first performed to manage the aortic coarctation, followed by tumor resection laparotomy. Intraoperative and histopathological findings confirmed a giant mucinous LPS originating from the transverse colon mesentery. Postoperatively, the patient underwent chemotherapy and regular follow-up CT. Although the rectal tumor did not recur, the mesenteric tumor showed extensive recurrence, compressing the intestinal lumen and causing mechanical obstruction, which severely threatened the patient's life. A second operation temporarily relieved the obstructive symptoms; however, it had a limited effect on tumor progression. The patient died four months later due to disease progression.
While no standardized treatment exists for MLPS co-occurring with multiple diseases, operation remains the mainstay. However, recurrence, metastasis, and poor postoperative prognosis continue to pose serious threats to patient survival.
脂肪肉瘤（LPSs）是起源于脂肪细胞的恶性间叶组织肿瘤。黏液样脂肪肉瘤（MLPS）是一种常见亚型，主要发生于四肢、腹膜后和深部软组织，在胃肠道中罕见。原发性肠系膜脂肪肉瘤尤其少见，特别是在横结肠系膜。
本报告描述了一名65岁女性患者，该患者因腹胀就诊，被诊断为横结肠系膜巨大黏液性脂肪肉瘤。入院后，患者接受了全面评估。胸部和腹部增强计算机断层扫描（CT）显示一个伴有主动脉夹层的大型恶性肿瘤，而结肠镜检查发现直肠癌。鉴于患者病情和手术风险，首先进行了介入手术以处理主动脉缩窄，随后通过剖腹手术进行肿瘤切除。术中及组织病理学检查结果证实为起源于横结肠系膜的巨大黏液性脂肪肉瘤。术后，患者接受了化疗并定期进行CT随访。尽管直肠肿瘤未复发，但肠系膜肿瘤出现广泛复发，压迫肠腔并导致机械性梗阻，严重威胁患者生命。第二次手术暂时缓解了梗阻症状；然而，对肿瘤进展的影响有限。患者4个月后因疾病进展死亡。
虽然对于合并多种疾病的MLPS尚无标准化治疗方法，但手术仍然是主要治疗手段。然而，复发、转移以及术后预后不良继续对患者生存构成严重威胁。
