Nishimura Seitaro, Kurose Yohei, Doi Rentaro, Noso Toru, Miura Naoko, Ishikawa Wataru, Takakura Norihisa
Department of Surgery, Fukuyama City Hospital, 5-23-1 Zaocho, Fukuyama, Hiroshima 721-8511, Japan.
J Surg Case Rep. 2025 Jul 28;2025(7):rjaf572. doi: 10.1093/jscr/rjaf572. eCollection 2025 Jul.
Despite a favorable prognosis, well-differentiated retroperitoneal liposarcoma (WDLPS) recurs frequently. Although extended resection is advocated, its survival benefit is unclear and organ-preservation may be considered. A 46-year-old woman underwent hysterectomy, left salpingo-oophorectomy, and retroperitoneal tumor resection for a pelvic mass diagnosed as WDLPS. Three years later, a recurrence involving the rectum, pelvic sidewall, and vaginal stump occurred. Considering the well-differentiated appearance of the tumor on imaging, its unclear origin, potential multicentricity, lack of evidence supporting extended resection, and the patient's desire to preserve the organs, we chose laparoscopic tumor resection with partial vaginectomy. We performed successful tumor removal with negative margins and transvaginal extraction using a specimen bag. Pathology confirmed recurrent WDLPS. The patient remained recurrence-free 6 years postoperatively. Laparoscopic organ-preserving surgery is a feasible minimally invasive option for treating recurrent WDLPS in appropriate patients. Individualized decision-making is essential because evidence for extended resection is lacking.
尽管预后良好,但高分化腹膜后脂肪肉瘤(WDLPS)仍频繁复发。虽然提倡扩大切除,但生存获益尚不明确,可考虑保留器官。一名46岁女性因盆腔肿块被诊断为WDLPS,接受了子宫切除术、左侧输卵管卵巢切除术和腹膜后肿瘤切除术。三年后,肿瘤复发累及直肠、盆腔侧壁和阴道残端。考虑到影像学上肿瘤的高分化表现、起源不明、潜在多中心性、缺乏支持扩大切除的证据以及患者保留器官的意愿,我们选择了腹腔镜肿瘤切除联合部分阴道切除术。我们成功切除肿瘤,切缘阴性,并使用标本袋经阴道取出标本。病理证实为复发性WDLPS。患者术后6年无复发。对于合适的患者,腹腔镜保留器官手术是治疗复发性WDLPS的一种可行的微创选择。由于缺乏扩大切除的证据,个体化决策至关重要。