腹膜后脂肪肉瘤联合胰腺切除15例临床分析

目的探讨腹膜后脂肪肉瘤联合胰腺切除的可行性和安全性。方法回顾性分析2014年10月至2016年10月北京大学肿瘤医院软组织与腹膜后肿瘤中心收治的15例行联合胰腺切除的腹膜后脂肪肉瘤病人的临床资料,其中8例病人联合胰十二指肠切除,7例病人联合胰体尾及脾切除。随访15(3~27)个月,观察术后疗效。结果 15例病人均顺利完成手术。手术时间为420(240～1020)min,术中出血1200(200～6000)mL。术后病理学检查示,7例病人肿瘤侵犯了胰腺实质,6例肿瘤侵犯了胰腺被膜。15例病人均联合结肠部分切除,6例联合血管切除和替代,10例联合一侧肾及肾上腺切除,其余5例既往手术已切除肾脏,6例行膈肌部分切除及修补,2例联合肝脏切除。术后8例病人发生胰瘘,其中A级5例,B级3例;Clavien-Dindo分级Ⅲa级并发症3例、Ⅴ级1例(术后3个月死亡)。结论联合胰腺切除在腹膜后脂肪肉瘤手术中安全可行,为一种可选择的术式。     

原发性腹膜后脂肪肉瘤一例

患者，女性，36岁，因左侧腰背部肿物二十余天入院，既往2个月前于当地医院行手术治疗，肿物未完全切除，术后诊断为腹带脓肿，术后四十余天，     

巨大腹膜后脂肪肉瘤一例

患者:男,49岁。因左下腹部肿物1年入院。体检:消瘦病容,腹部高度隆起,可触及30ｃｍ×25ｃｍ肿物,呈结节状,质中等硬,活动差,无压痛。Ｂ型超声、ＣＴ报告为腹膜后肿瘤。在硬膜外麻醉下行剖腹探查术。术中见肿瘤表面呈结节状,有完整被膜,基底部广泛粘连,占据大部分腹腔,完整切除肿瘤。肿瘤重8800ｇ。病理报告:腹膜后脂肪肉瘤。脂肪肉瘤属于软组织肉瘤的一种,仅占恶性肿瘤的1%,临床上少见。主要临床表现为腹部肿块,Ｂ型超声、ＣＴ多能帮助诊断。手术加放疗疗效最好,分化好的5年存活率可达70%～80%。巨大腹膜后脂肪肉瘤一例@刘宏业!161600$黑龙…     

腹膜后巨大脂肪肉瘤一例

腹膜后脂肪肉瘤是一种少见的恶性肿瘤，早期不易发现，手术彻底切除较困难，术后易复发。现将我院收治的1例腹膜后巨大脂肪肉瘤报道如下。[第一段]     

开腹减压后择期行腹膜后巨大脂肪肉瘤切除一例

正患者,女,78岁。入院体质指数(BMI)17.6 kg/m~2。以腹膜后脂肪肉瘤术后8年余,复发1年余为主诉入院。8年前自觉腹胀至外院就诊,CT检查提示腹腔巨大占位性病变,行腹腔巨大肿瘤切除术,术后病理检查提示高分化脂肪肉瘤。免疫组化:S-100(+),CD34     

腹膜后黏液样脂肪肉瘤术后复发成功切除一例

患者男,74岁,因"发现右上腹肿物半个月余"于2007年12月17日入院.体格检查:右侧腹可触及一约8 cm×6 cm大小肿物,可推动、无压痛,辅助检查:腹部B超:腹后腔实质性肿块,大小约12.2 cm × 10.5 cm × 10.8 cm.CT检查:右侧腹膜后肿块大小约13.5 cm×13.2 cm×10.6 cm,其内见片状钙化影及小片状囊变区.     

腹膜后罕见巨大脂肪肉瘤一例

患者女性，37岁，身高157crfl，体质量72kg。因发现腹部肿物6年余，迅速增大1年于2008年3月入院。入院查体：一般状况差，恶病质貌，血压130／80mmHg，心率74次／min，双下肢轻度水肿。     

腹膜后巨大脂肪肉瘤一例报告

患者：男,２８岁。主诉食欲下降、上腹饱胀３月,发热、乏力一周。１０年前自感左上腹有一拳头大小肿块。体检：消瘦,左侧腹饱满,可触及一巨大肿块,下界达脐下４横指,无压痛。Ｂ型超声检查：左上腹实质性占位性病变。ＣＴ检查示：脾、胃间有一圆形肿块,下极达髂棘联...     

腹膜后巨大脂肪肉瘤一例报告

患者,女,62岁,因腹部肿物进行性增大,腹胀,消瘦二个月来诊,两年前因患腹膜后脂肪瘤手术治疗,切除肿瘤重达6.5ｋｇ。入院后检查:生命体征平稳、心肺正常。腹部略膨隆,中腹部可触及20ｃｍ×20ｃｍ肿物,表面光滑,边界不清,活动度不佳,叩诊实音,无移动性浊音,肠鸣音正常。ＣＴ报告为腹膜后脂肪瘤,心电图检查正常,择期手术治疗。术中见腹膜后巨大肿物,以左腹膜后为主,上达肋弓,左侧抵侧腹壁,右侧达结肠肝曲,下界达盆腔,结肠系膜向前顶起,横结肠、降结肠被挤压变扁,左肾被推移到脊柱前弓右侧,打开后腹膜,见肿物呈分叶状,包膜完整,分离别剔除肿物,…     

腹膜后多发去分化脂肪肉瘤一例

腹膜后肿瘤多为脂肪瘤及脂肪肉瘤,去分化脂肪肉瘤是指分化好的脂肪肉瘤中出现高度恶性非脂肪源性的梭形细胞肉瘤,此病理类型在临床少见.我科收治1例腹膜后去分化脂肪肉瘤患者,总结报道如下.     

Giant retroperitoneal liposarcoma

Liposarcoma is a malignant tumor that has an embryologic origin from mesodermal tissue depending on fatty tissue. Although liposarcoma is only 0.1% of all human neoplasms, it is the most common histology subtype of retroperitoneal soft tissue sarcomas. This tumor grows slowly. Diffuse abdominal pain is its most frequent symptom and abdominal mass is the most common sign. Aggressive surgical treatment is basic to get a complete resection and a local disease control. This objective is difficult because of the large tumor size it gets in the retroperitoneal location and the multiorgan involvement that require the resection of a high percentage of contiguous organs. We report a case of a giant retroperitoneal liposarcoma presenting like continuous left hemiabdominal pain because of the visceral compression. The right kidney was involved and suffering from renal vessel enlargement without renal function. There is a high probability of microscopic residual disease and a good follow-up of the patients is necessary as well as an adjuvant radiation therapy in some cases.     

Calcified retroperitoneal liposarcoma

Case report of a retroperitoneal liposarcoma pleomorfico with calcification in diagnosed in our hospital. We comment on its clinical characteristics, diagnostic methods and treatment. We likewise comment the possible differential diagnoses.     

Giant retroperitoneal liposarcoma

Liposarcoma is a malignancy of fat cells and is the most frequent soft tissue sarcoma localized in the retroperitoneum. It can reach substantial proportions. It is a slow-growing tumor, and the most frequent symptom is nonspecific abdominal pain and diffuse abdominal enlargement. Treatment is radical surgery and complete resection is essential for local control of the disease. We present a case of giant right retroperitoneal liposarcoma, which was well-encapsulated and could be completely excised. The patient is currently in follow up and at 2 years is disease-free.     

Giant retroperitoneal liposarcoma

Liposarcomas are one of the most common soft tissue sarcomas of adulthood. Liposarcomas are remarkable because of their frequently large size. We report a case with an extremely large dedifferentiated liposarcoma that weighed 18 kg. Although it was capsulated and could be excised en bloc, the patient suffered a relapse 9 months later and died 1 year after the operation.     

Giant dedifferentiated retroperitoneal liposarcoma

A 72 years old lady presented with a gradually increasing abdominal mass for the last 25 years, with more rapid increase in the last 05 years. Examination revealed a large mass spanning the whole abdomen. CAT scan revealed a huge retroperitoneal tumour, with tortuous ureters passing through the tumour and three tiny nodules in the right lung field. A subtotal piecemeal excision of the tumour was done after stenting the ureters with single J stents. The excised tumour mass weighed 46 Kg. The patient had a prolonged ileus that recovered in 5 days. Histopathology revealed the mass to be dedifferentiated liposarcoma. The patient and the family were satisfied with the short-term outcome of the surgery. She was ambulating with little support and was able to manage her daily affairs.