Springfield D
Department of Orthopaedics, Musculoskeletal Oncology, Massachusetts General Hospital, Boston 02114.
Clin Orthop Relat Res. 1993 Apr(289):50-7.
Liposarcoma is second in frequency only to malignant fibrous histiocytoma among the soft-tissue sarcomas. It occurs almost exclusively in adults and is found most often in the thigh or retroperitoneum. It rarely arises from a lipoma and does not occur in the subcutaneous tissues. Liposarcomas are divided into histologic subtypes with different microscopic appearances and slightly different behavior characteristics. Surgical resection with a wide surgical margin is the treatment of choice. When amputation is required to obtain an adequate surgical margin, local irradiation can be used as an adjuvant and a limb-sparing operation can be done. Currently, no evidence exists that adjuvant chemotherapy is indicated for patients with liposarcoma, although numerous studies are being done to investigate its use. As is the case for all sarcomas, the lung is the most common site of metastasis; however, liposarcoma has an unusual propensity to metastasize to the retroperitoneum, mediastinum, and bone.
脂肪肉瘤在软组织肉瘤中发病率仅次于恶性纤维组织细胞瘤。它几乎仅发生于成年人，最常出现在大腿或腹膜后。它很少由脂肪瘤恶变而来，且不出现在皮下组织。脂肪肉瘤可分为具有不同微观表现和略有不同行为特征的组织学亚型。手术切缘广泛的手术切除是首选治疗方法。当需要截肢以获得足够的手术切缘时，局部放疗可作为辅助治疗，并且可以进行保肢手术。目前，尚无证据表明脂肪肉瘤患者需要辅助化疗，尽管正在进行大量研究来探讨其用途。与所有肉瘤一样，肺是最常见的转移部位；然而，脂肪肉瘤有转移至腹膜后、纵隔和骨骼的特殊倾向。
