Evans H L, Khurana K K, Kemp B L, Ayala A G
Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Am J Surg Pathol. 1994 Nov;18(11):1150-7. doi: 10.1097/00000478-199411000-00009.
Five cases of dedifferentiated liposarcoma in which heterologous elements were present in the dedifferentiated component are presented. Two patients, men 54 and 66 years of age, had retroperitoneal atypical lipomatous tumors (well-differentiated liposarcomas) that recurred (after 2.5 and 12 years, respectively) as dedifferentiated liposarcomas with rhabdomyosarcomatous elements in the dedifferentiated components. The third patient, a 63-year-old woman, had a retroperitoneal dedifferentiated liposarcoma whose dedifferentiated component demonstrated focal osteoid formation. The fourth patient, a 36-year-old woman, had two seemingly separate retroperitoneal masses, one composed of atypical lipomatous tumor with foci of smooth muscle and the other of leiomyosarcoma; despite the apparent separation, it was thought more logical to consider this a dedifferentiated liposarcoma with leiomyosarcoma as the dedifferentiated component than two unrelated neoplasms. The fifth patient, a 45-year-old man, had a mediastinal dedifferentiated liposarcoma with angiosarcomatous areas in the dedifferentiated component. The relatively short follow-up thus far available on these cases has not demonstrated tumor behavior significantly different from that of dedifferentiated liposarcoma as a whole.
本文报告了5例去分化脂肪肉瘤，其去分化成分中存在异源性成分。2例患者，分别为54岁和66岁男性，患有腹膜后非典型脂肪瘤性肿瘤（高分化脂肪肉瘤），分别在2.5年和12年后复发为去分化脂肪肉瘤，去分化成分中含有横纹肌肉瘤成分。第3例患者，一名63岁女性，患有腹膜后去分化脂肪肉瘤，其去分化成分显示局灶性类骨质形成。第4例患者，一名36岁女性，有两个看似独立的腹膜后肿块，一个由非典型脂肪瘤性肿瘤组成，伴有平滑肌灶，另一个为平滑肌肉瘤；尽管表面上是分开的，但认为将其视为以平滑肌肉瘤为去分化成分的去分化脂肪肉瘤比视为两个不相关的肿瘤更符合逻辑。第5例患者，一名45岁男性，患有纵隔去分化脂肪肉瘤，其去分化成分中有血管肉瘤区域。目前对这些病例的随访时间相对较短，尚未显示出肿瘤行为与整体去分化脂肪肉瘤有显著差异。
