腹股沟皮下梭形细胞脂肪瘤1例。

Q4 Medicine Japanese Journal of Urology Pub Date : 2020-01-01 DOI:10.5980/jpnjurol.111.102
Kenichi Sasaki, Masaki Kimura, Akihiko Sakamoto, Kaori Endo, Atsushi Kanatani, Sayuri Takahashi, Yukio Yamada, Tsuyoshi Ishida, Satoshi Abe, Hirotaka Kawano, Hideyo Miyazaki, Tohru Nakagawa
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摘要

一名39岁的男子被转介到我们进一步检查右腹股沟肿块。他在几个月前就发现了这个肿块,并进行了正电子发射断层扫描/计算机断层扫描,显示右侧腹股沟皮下有一个肿块,SUVmax为1.48。磁共振成像(MRI)显示一长7cm、边界清楚、不均质强化的脂肪肿瘤,邻近右侧精索和海绵体,边界清晰。该肿瘤疑似非典型脂肪瘤(高分化脂肪肉瘤),并行肿瘤切除手术。术中未打开右侧腹股沟管,安全保留右侧精索和海绵体。切除标本宏观上由脂肪瘤组织组成。组织病理学诊断为梭形细胞脂肪瘤。梭形细胞脂肪瘤是相对罕见的良性肿瘤,仅占所有脂肪瘤肿瘤的1.5%。它们最常见于肩部和颈部后部,很少发生在腹股沟。鉴别诊断包括非典型脂肪瘤性肿瘤,但由于MRI上的相似表现,影像学诊断往往很困难。梭形细胞脂肪瘤通常表现为皮下肿瘤,而非典型脂肪瘤则出现在结缔组织的深层。这种肿瘤部位的差异可能有助于他们在手术前的鉴别诊断。
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[A CASE OF SPINDLE CELL LIPOMA ARISING IN THE INGUINAL SUBCUTIS: A CASE REPORT].

A 39-year-old man was referred to us for further examination of a right inguinal mass. He had noticed the mass several months prior and had undergone positron emission tomography/computed tomography, which revealed a mass with an SUVmax of 1.48 at the right inguinal subcutis. Magnetic resonance imaging (MRI) showed a well-circumscribed, heterogeneously enhanced adipose tumor 7cm in length, adjacent to the right spermatic cord and corpora cavernosa with clear boundaries. The tumor was a suspected atypical lipomatous tumor (well-differentiated liposarcoma), and he underwent tumor extirpation surgery. At surgery, the right inguinal canal was not opened, and the right spermatic cord and corpora cavernosa were safely spared. The excised specimen was composed of lipomatous tissue macroscopically. Histopathological diagnosis was of a spindle cell lipoma. Spindle cell lipomas are relatively rare, benign tumors, comprising only 1.5% of all lipomatous tumors. They arise most commonly in the shoulder and posterior region of the neck, and rarely develop in the groin. Differential diagnosis includes atypical lipomatous tumors, but radiological diagnosis is often difficult because of similar findings on MRI. Spindle cell lipomas typically present as a subcutaneous tumor, while atypical lipomatous tumors arise in the deep layers of connective tissue. This difference in the site of the tumor may contribute to their differential diagnosis before surgery.

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Japanese Journal of Urology
Japanese Journal of Urology Medicine-Urology
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