腹膜后去分化脂肪肉瘤伴肾压缩无侵犯:一例罕见病例报告

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urological Science Pub Date : 2021-05-01 DOI:10.4103/UROS.UROS_60_20
Shang-Rong Zhong, Thomas Y. Hsueh, J. Chou
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引用次数: 0

摘要

一位68岁的女性患者在半年内体重明显下降。通过非强化腹部计算机断层扫描在左侧腹膜后间隙发现一个异质性巨大肿瘤。肿瘤对邻近器官和结构产生了肿块效应,左肾轮廓模糊不清。增强肾磁共振成像显示其高血管内容物和清晰的边界。根治性切除是通过开放式入路进行的。肿块长25厘米,重约5公斤。大体上,伴有压迫但无侵犯的肾脏。诊断为去分化脂肪肉瘤,并确定了病灶累及的边缘。腹膜后肉瘤的年平均发病率为2.7例/百万。腹膜后软组织肉瘤很少引起症状,直到肿瘤对邻近器官产生大规模影响。这名患者的肿瘤突出表现为压迫但无侵犯的左肾。手术切除被认为是唯一可能的治疗方法。由于肿瘤呈现时体积大,范围广,通常导致可切除性有限或阳性边缘。腹膜后肉瘤的重要预后因素包括手术切缘、肿瘤分级、分化程度和组织学亚型。去分化脂肪肉瘤预后较差,毛缘阳性意味着局部复发的几率更高,死亡率也更高。
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Retroperitoneal dedifferentiated liposarcoma with a compressed invasion-free kidney: A rare case report
A 68-year-old female patient presented an evident drop in weight within half a year. A heterogeneous huge tumor was found in the left retroperitoneal space through a nonenhanced abdominal computed tomography. The tumor contributed mass effect on adjacent organs and structures, with equivocal left kidney outline. Enhanced kidney magnetic resonance imaging illustrated its hyper-vascular content and clear border. Radical excision was performed through an open approach. The mass was 25 cm in length and weighed about 5 kg. Grossly, it was accompanied by a compressed but invasion-free kidney. The diagnosis of dedifferentiated liposarcoma was made, and a focally involved margin was identified. The average annual incidence of retroperitoneal sarcomas is 2.7 cases/million. Retroperitoneal soft-tissue sarcoma seldom induces symptoms until the tumor makes a mass effect on adjacent organs. The tumor of this patient stands out as the compressed, yet invasion-free left kidney. Surgical resection is regarded as the only potential curative therapy. Due to the large size at presentation and wide extent of the tumor, it often results in limited resectability or positive margin. Important prognostic factors of retroperitoneal sarcoma involve surgical margin, tumor grade, differentiation, and histologic subtype. Dedifferentiated liposarcoma has a worse prognosis and a positive gross margin implies a higher chance of local recurrence as well as a higher mortality rate.
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来源期刊
Urological Science
Urological Science UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
26
审稿时长
6 weeks
期刊最新文献
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