原发性腹膜后恶性肿瘤的诊断和治疗

【目的】探讨原发性腹膜后恶性肿瘤的诊断及治疗方法。【方法】回顾性分析1994年5月至2004年8月收治的9例原发性腹膜后恶性肿瘤的临床资料。【结果】9例中有5例首发症状为腹部包块。B超阳性率87．5％，CT及MRI阳性率均为100％。病理结果为脂肪肉瘤3例，平滑肌肉瘤2例，恶性淋巴瘤，恶性畸胎瘤，恶性神经鞘瘤，恶性间质瘤各1例。完整切除者6例次，部分切除12例次，活检1例次。完整切除者1、3、5年生存率分另q100％、60％、40％，部分切除者1、3、5年生存率分别为75％、25％、0％。【结论】原发性腹膜后恶性肿瘤术前主要靠影像学检查诊断。手术完整切除是治疗的关键因素，患者复发率高，再次手术仍是治疗复发性膜膜后恶性肿瘤的有效手段。

Diagnosis and Treatment of Malignant Primary Retroperitoneal Tumor in 9 cases

[Objective]To explore the diagnosis and treatment of malignant primary retroperitoneal tumor （MPRT）. [Methods] Clinical data of 9 patients with MPRT from May 1994 to August 2004 were retrospec- tively analyzed. [Results]Among the 9 Cases, the initial symptom of 5 cases was abdominal mass. The posi tive rate of B-ultrasound was 87.5%, while that of CT and MRI was 100%. The pathological patterns were varied and there were 3 cases with lipoblastomas, 2 leiomyosarcomas, 1 malignant lymphoma, 1 malignant teraroma, 1 malignant schwannoma, and 1 malignant stromal tumor. Six cases underwent complete resection, 12 cases underwent partial resection and I case received biopsy without resection. The 1-, 3- and 5-year survival rate of the patients who underwent resection was 100%, 60% and 40%, respectively. However that of partial resection was 75%, 25% and 0%, respectively. [Conclusion]The image examinations were the main methods to detect MPRT. Complete resection is the key factor for the treatment of MPRT. The recurrent rate of MPRT is high. Re-operation is the effective treatment for the recurrent tumor.