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]     

腹膜后巨大脂肪肉瘤1例

1病历简介病人女性,68岁。于2008-09-18来我院就诊,以腹腔肿物收入院。入院前3个月出现腹胀,无腹痛,无呼吸困难,无恶心呕吐,排黄色稀便,入院前1个月前行CT检查发现腹膜后巨大占位病变,入院查体:T37.0℃,P82次/分,     

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，     

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术后并发脂肪栓塞综合征1例报告

腹膜后巨大脂肪肉瘤术后并发脂肪栓塞综合征１例报告李英军脂肪栓塞综合征（ＦａｔＥｍｂｏｌｉｓｍＳｙｎｄｒｏｍｅ，ＦＥＳ）是发生在严重创伤，特别是长管状骨骨折和骨盆骨折的严重并发症。作者遇一患者因腹膜后巨大脂肪肉瘤术后并发ＦＥＳ，报告如下：患者女，７０岁...     

腹膜后巨大脂肪肉瘤破裂大出血救治成功一例

病人,男,47岁.因左腿部脂肪肉瘤术后4 年,腹痛腹胀1 个月于2019 年9月入院.2015 年3月确诊为左大腿低分化脂肪肉瘤并行手术切除治疗,并于2015 年9月、2016年12月出现2次局部复发.近1 个月因腹胀,体重下降3 kg,门诊行全腹增强 CT 提示:腹腔巨大肿块,考虑转移瘤.体格检查:左侧腹部可触及巨大...     

腹膜后巨大脂肪肉瘤4次手术切除1例报告

病人女性,5 4岁。自1992年以来,因“腹膜后脂肪肉瘤3次术后复发”于2 0 0 3年4月15日第4次住院。入院前2个月再次发现包块,约10 0cm×7 0cm。腹胀,食欲不振,全身乏力,明显消瘦。上腹部可及一儿头大包块,质硬,表面不平,不活动,边界不清,边缘不整。腹部B超检查:肝内多发性转移瘤并侵及胆囊,肝门区淋巴结肿大。上消化道钡餐示十二指肠降段被右上腹包块推压变形移位。腹部CT平扫示右腹膜后巨大类圆形低密度肿块,其内见不规则条形间隔,肿块向下延伸与右肾相连,界面不清。全麻后右上腹旁正中切口剖腹,腹腔内无出血及渗液,可见广泛粘连,松解之。…     

原发性腹膜后脂肪肉瘤23例报道

目的总结原发性腹膜后脂肪肉瘤(primary retroperitoneal liposarcoma,PRL)的临床病理特征、诊断及治疗方法。方法回顾性分析经手术和活检证实的23例PRL患者的临床病理资料。结果首发症状及体征表现为腹部肿块(91.3%,21/23),腹胀(56.5%,13/23)及腹痛(30.4%,7/23)。B超及CT的定位诊断准确率分别为66.7%(12/18)和85.7%(12/14)。首次手术肿瘤完整切除16例(69.6%),其中8例联合脏器切除;部分切除3例(13.0%);仅行活检4例(17.4%)。PRL肿瘤完整切除术后复发率为75.0%(12/16),该12例中再次手术8例(66.7%)可完全切除肿瘤。结论CT是诊断PRL的重要手段,优于B超;手术以完整切除肿瘤为主,对侵犯脏器者采用累及脏器一并切除;术后复发者可再次手术。     

腹膜后脂肪肉瘤15例分析

作者报告10年中收治的腹膜后脂肪肉瘤15例.术前根据病人年龄较大、病史较短、腹部可触及能轻微左右移动的巨大平软或中等深在肿块等特点,若病人全身情况较好,再结合消化道钡餐、B超、CT等检查,可初步诊断、定位和了解与周围组织关系.治疗主张尽可能整块或大部切除,对复发者争取再次、多次手术切除,如有困难术中不要勉强切除.15例中整块或大部切除11例.15例中已有5例死亡,多为不能切除者,大部切除的病例目前已有3例分别作了4次、3次、2次手术,存活时间最长已10年,最短2年,整块全切除复发率低,疗效较好.     

Giant recurrent retroperitoneal liposarcoma initially presenting as inguinal hernia: Review of literature

INTRODUCTIONLiposarcomas comprise around 15% of soft tissue tumors. These tumors of mesodermal origin arise as single tumors, present one histologic type and diverse locations (including the retroperitoneum). Diagnosis of liposarcomas of retroperitoneum is difficult because of this unspecific presentation and in 50–100% of the cases there is recurrence from residual tissue.PRESENTATION OF CASEAn 86 year old male patient was admitted in 1996 due to a right and voluminous inguinal hernia. During the herniaplasty, a right paratesticular tumor was isolated and removed. The histologic exam revealed a well-differentiated liposarcoma. A CT scan was performed and a large abdominal mass was detected. The patient underwent a laparotomy and an incomplete resection of the tumor was achieved. After the surgery the patient remained asymptomatic during a long period. Nine years later, the patient underwent another laparotomy with partial removal of the giant recurrent retroperitoneal liposarcoma.CONCLUSIONThe purpose of this publication is to report the recurrence of giant retroperitoneal liposarcoma, which is an unusual presentation in surgery today. Furthermore, we would like to emphasize the long-term survival of this patient despite partial resection and the possibility of performing a re-resection in this type of cases.     

Primary retroperitoneal liposarcoma: A case report and review of the literature

We report a case of a 43 years old woman with a retroperitoneal liposarcoma located in the left iliac fossa. The condition was discovered because of the association of left flank pain, abdominal distention and persistent urinary infection with symptoms of vesical irritation. The diagnosis was suggested by intravenous pyelography (IVP), abdominal and pelvic ultrasonography (USG) and computed tomography (CT). Treatment was exclusively surgical. During a six-month follow-up, no recurrence was observed.     

Pleomorphic spermatic cord liposarcoma: A case report and review of management

Liposarcoma of the spermatic cord is very rare, representing about 7% of para testicular sarcomas. It is considered to be one of the highest malignancy grades.We present a case of a liposarcoma of the spermatic cord in a 45-year-old male complaining of a progressive painless swelling in the right inguinoscrotal region. Ultrasonography and computed tomography findings were compatible with liposarcoma of the spermatic cord. We performed a right radical orchiectomy with a wide resection of the mass. Histological examination confirmed the diagnosis and showed a pleomorphic subtype.The mainstay of management of spermatic cord liposarcoma is wide excision with radical orchiectomy. The most important factors for prognosis are the histologic subtype and surgical margin status. Adjuvant radiotherapy should be considered in cases at high risk for local recurrence. Long-term surveillance is mandatory.Liposarcoma of the spermatic cord is an uncommon para testicular tumor which should be part of the differential diagnosis of inguinoscrotal mass. A radical inguinal orchiectomy with wide resection of the soft tissue mass and the spermatic cord are the key to longest local and systemic disease-free survival.     

巨大腹膜后平滑肌肉瘤伴出血1例报告并文献复习

目的:探讨腹膜后平滑肌肉瘤的临床特点、影像学表现及治疗策略,以期对类似病例的诊治提供参考。方法:回顾性分析收治的1例腹膜后平滑肌肉瘤患者临床资料,并复习相关文献。结果:患者腹部胀痛伴贫血,影像学提示中下腹部恶性肿瘤伴出血,早期行液体复苏,进一步介入栓塞,超声引导下穿刺引流,避免腹腔隔室综合征的发生;复查待瘤体缩小,贫血纠正,行完整切除肿瘤,病理诊断为平滑肌肉瘤。术后随访16个月,患者恢复良好。结论:腹膜后平滑肌肉瘤是一种罕见的恶性肿瘤,起病隐匿,易复发和转移,手术完整切除是其主要治疗方式,配合以化疗、放疗等手段综合治疗,可改善患者预后。     

Fetus-in-fetu: report of a case and a review of the literature

A 2-week-old girl was found to have an asymptomatic abdominal mass on routine examination. Surgical removal revealed the mass to have 4 limb buds situated relative to a palpable vertebral column. Karyotyping revealed the mass to be 46 XX. The mass was therefore diagnosed as a case of fetus-in-fetu. The literature on this rare entity is reviewed, and the diagnosis and pathogenesis of the disease are discussed.     

Huge liposarcoma of the left retroperitoneum

Liposarcoma is one of the most common soft-tissue sarcomas. Unless it grows to massive proportions, it rarely causes symptoms. A 64-year-old man presented with weight loss, asthenia, and increasing abdominal girth caused by a large liposarcoma in the left retroperitoneum. Despite resection with sarcoma-free margins and intensive follow-up evaluation, he died of a tumor recurrence 2 years later. Complete surgical resection of the liposarcoma is the only curative option, but establishing a prognosis remains a challenge.     

Primary lesser sac myxoid liposarcoma: A case report

IntroductionLesser sac pathological entities are uncommon. Most of these are tumors and are generally misdiagnosed as retroperitoneal lesions.Case reportA 62 year old male with past history of treated hypopharyngeal cancer presented with progressive abdominal distension. Physical examination revealed a midline intra abdominal mass in the epigastrium and umbilical region. Radiological investigations were suggestive of a retroperitoneal tumor,an image guided biopsy was reported as atypical lipoma. Surgical exploration confirmed a large multi lobulated tumor arising primarily from the lesser sac, post operative histopathological examination confirmed a myxoid liposarcoma.DiscussionPrimary lesser sac tumors are rare, a literature review of primary lesser sac tumors with particular reference to myxoid liposarcoma is presented.ConclusionPrimary lesser sac liposarcomas are rare neoplasms. The myxoid variant is unique for its peculiar biological behavior, in its sensitivity to chemotherapy and radiotherapy and for the presence of specific cytogenetic marker.     

原发性腹膜后脂肪肉瘤的诊断与治疗

目的 探讨原发性腹膜后脂肪肉瘤（primary retroperitoneal liposarcoma,PRPLS）的临床病理特点、诊治及预后.方法 对华中科技大学同济医学院附属协和医院普通外科初诊的43例PRPLS患者临床病理资料进行回顾性分析.结果 43例PRPLS患者中男性32例,女性11例,年龄22~75岁,中位年龄49岁.肿瘤平均大小（17.6＆#177;10.8） cm.行CT检查38例,定性准确率为81.3%;行MRI检查8例,定性准确率为80.0%.43例患者均接受手术,其中首次手术肿瘤完整切除者40例,联合切除率为32.5%,中位随访39个月,首次手术完整切除且未复发的患者3、5年生存率分别为85.0%、80.0%,术后复发患者3、5年生存率为72.2%、61.1%.结论 PRPLS早期诊断较为困难,CT和MRI是PRPLS诊断和术后复查的重要手段.PRPLS首次手术应争取完整切除肿瘤,对大多数复发病例仍应以积极手术治疗为主,完整切除仍可获得较好的预后.     

腹膜后肠道重复畸形一例报告并文献复习

目的探讨肠道重复畸形的基本情况、病理与临床特点、诊断和治疗效果。 方法收集2016年9月份广东省人民医院泌尿外科收治的1例30岁男性患者资料，患者因"发现左侧肾上腺肿物1个月"入院，术前增强CT提示腹膜后左侧肾上腺区见圆形囊性低密度肿块，考虑左侧肾上腺囊性占位，良性，囊肿可能性大。完善检查后在我科行后腹腔镜下左侧肾上腺肿物切除术，术中冰冻病理检查提示囊性病变，未见恶性证据。 结果术后结合病理诊断为腹膜后肠道重复畸形，患者恢复良好，目前仍在随访当中。 结论腹膜后肠道重复畸形临床上罕见，临床表现不典型，影像学、实验室检查多无特异性，临床工作中易发生误诊，最终需病理明确诊断，手术完整切除为最佳治疗方式。     

The retroperitoneal liposarcoma: a case report

A 62-year-old woman was admitted to our hospital because of a mass in the right abdomen. Ultrasonography, aortography and computed tomographic (CT) scanning revealed the right kidney displaced by a huge and avascular mass containing fatty tissue. Also magnetic resonance imaging (MRI) indicated that it was contained of lipomatous tissue and demonstrated the mass occupying the entire right abdominal cavity. The tumor including the right kidney was resected, following diagnosis of the retroperitoneal tumor. The exercised tumor measured 28 X 22 X 18 cm and weighed 2,010g. The histological diagnosis was well-differentiated liposarcoma. She has been healthy for three months following postoperative chemotherapy. Many reports have been made on the ultrasonographic and CT appearance of retroperitoneal liposarcoma, but few have been made on the MRI appearance. According to our case, imaging diagnosis by MRI also seems to be useful in making a histological diagnosis of liposarcoma.