腹膜后脂肪肉瘤:揭示诊断延误和多模式治疗困境。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Archive of clinical cases Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI:10.22551/2023.41.1004.10272
Vlad Ionuţ Vlăsceanu, Radu Petru Soroceanu, Daniel Vasile Timofte, Andi Gabriel Iordache, Cristina Ciobanu Strobescu, Sergiu Timofeiov
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摘要

脂肪肉瘤是软组织肉瘤的一种常见亚型,占所有恶性肿瘤的 1%以下。脂肪肉瘤起源于脂肪组织,可表现在不同部位,世界卫生组织将其分为几种亚型:分化良好的脂肪肉瘤、未分化的脂肪肉瘤、肌样脂肪肉瘤、多形性脂肪肉瘤和混合型脂肪肉瘤。这些肿瘤通常发生在中老年人身上,发病率逐年上升。随着脂肪肉瘤的发展,它们往往会包绕血管和主要器官,尤其是在腹膜后区域。最初往往没有症状,当肿瘤达到相当大的体积,对邻近组织和器官造成压力时,症状就会出现。本报告中的患者 54 岁,偶然被诊断出患有腹膜后巨大肿瘤,肿瘤通过右侧腹股沟韧带延伸至前外侧腹壁和大腿内侧。患者曾有三年右腹股沟肿块病史,因肛周脓肿就医。组织学检查显示,其形态与低级别肌样脂肪肉瘤一致。虽然手术仍是腹膜后脂肪肉瘤的主要治疗方法,但放疗和化疗在提高存活率方面的作用仍存在争议。本病例凸显了腹膜后肿瘤治疗的挑战,强调了采用个性化、多学科方法优化患者预后的重要性。
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Retroperitoneal liposarcoma: unveiling diagnostic delays and multimodal treatment dilemmas.

Liposarcomas are a prevalent subtype of soft tissue sarcomas, constituting less than 1% of all malignancies. Originating in the adipose tissue, they can manifest in various locations and are categorized by the World Health Organization into several subtypes: well-differentiated liposarcomas, dedifferentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and mixed-type liposarcomas. These tumors typically affect middle-aged and older individuals, and their incidence has been progressively increasing over the years. As liposarcomas advance they tend to encase blood vessels and major organs, particularly in the retroperitoneal area. Often asymptomatic initially, symptoms arise as the tumor reaches a considerable size, exerting pressure on adjacent tissues and organs. This report features a 54-year-old patient incidentally diagnosed with a substantial retroperitoneal tumor extending to the antero-lateral abdominal wall and inner thigh via the right inguinal ligament. The patient, with a previous three-year history of a right inguinal mass, sought acute care for a perianal abscess The histological examination revealed morphological aspects consistent with a low-grade myxoid liposarcoma. While surgery remains the primary treatment for retroperitoneal liposarcomas, controversies exist regarding the role of radiotherapy and chemotherapy in improving survival rates. This case highlights the challenges in managing retroperitoneal tumors and underscores the importance of a personalized, multidisciplinary approach to optimize patient outcomes.

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