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。

Huge retroperitoneal leiomyosarcoma with hemorrhage: an analysis of one case and literature review

Objective: To investigate the clinical features, imaging manifestation and treatment strategies of retroperitoneal leiomyosarcoma, so as to provide reference for the diagnosis and treatment of similar cases. Methods: The clinical data of one admitted patient with retroperitoneal leiomyosarcoma was analyzed retrospectively, and the relevant literature was reviewed.  Results: The patient had abdominal pain and anemia, and the preoperative imaging examination indicated a malignant tumor with hemorrhage in hypogastric region. The patient underwent fluid replacement therapy and interventional embolization first, and then ultrasound-guided puncture and drainage to avoid the occurrence of abdominal compartment syndrome. After tumor size reduction and anemia correction, the tumor was completely resected, and the pathological diagnosis was leiomyosarcoma. Postoperative follow-up was conducted for 16 months, and the patient had an uneventful recovery.  Conclusion: Retroperitoneal leiomyosarcoma is a rare malignant tumor, which has an insidious onset and is more likely to develop recurrence and metastasis. Complete surgical excision is the main treatment method, which in combination with multimodality therapy such as chemotherapy and radiotherapy can improve the prognosis of patients.