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巨大的腹腔内瘤,与脂肉瘤相容:一个病例报告和文献综述

Niu Dai^1,2, Juzheng Yuan¹, Xiaoyi Wang¹

¹Department of General Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China.

The American journal of case reports

|September 13, 2025

概括

巨型逆皮质脂肪瘤 (RPLS) 的管理需要外科专业知识. 这一案例突出显示了血管导向切除 (VOR) 和完全逆肠液瘤切除 (TRL) 进行彻底的瘤切除,强调了多学科的合作.

科学领域:

手术瘤学手术瘤学
胃肠道手术胃肠道手术
血管外科血管外科

背景情况:

逆脂肉瘤 (RPLS) 可以生长到巨大的尺寸,包围重要结构,并带来重大外科手术挑战.
化学疗法和放射治疗对RPLS的有效性有限,需要有效的外科手术策略.
整体手术切除 (R0) 是RPLS的主要治疗方法和最重要的预后因素.

研究的目的:

提供手术见解,用于管理巨型逆皮质脂肉瘤 (RPLS).
为了证明复杂的RPLS病例的联合手术方法的可行性.
强调RPLS切除中多学科合作和先进成像的重要性.

主要方法:

一个59岁的男性患者的病例报告,患有巨型逆皮质脂肪肉瘤.
术前成像与3D血管重建,以评估瘤的参与.
手术涉及血管导向切除 (VOR) 结合全身逆皮质脂切除 (TRL).

主要成果:

实现了完整的瘤去除 (R0),包括左和部分结肠.
手术后的康复显著改善,下肢胀和呼吸障碍的解决.
病理学证实了具有特定分子标记 (MDM2 / CDK4 +,Ki-67 10-30%) 的无差异化脂肉瘤.

结论:

血管导向切除 (VOR) 结合整体逆皮质脂切除 (TRL) 是巨型逆皮质脂肉瘤的可行方法.
术前3D血管重建和多学科合作对于成功的手术管理至关重要.
尽管取得了进展,但高5年复发率需要进一步研究RPLS的有效辅助疗法.

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