乙状结肠系膜多形性脂肪肉瘤1例报道并文献复习  

Pleomorphic liposarcoma of the sigmoid mesocolon:case report and literature review

作　　者：缪锦超 刘赞伟 林晓锋 黄家荣 施珊格 黄素梅 蔡世春 吴晖[2] 张信华[2] 

机构地区：[1]广东医科大学附属彭湃纪念医院普通外科,广东汕尾516400 [2]中山大学附属第一医院胃肠外科中心,广东广州510080

出　　处：《消化肿瘤杂志（电子版）》2017年第2期107-111,共5页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨结肠系膜脂肪肉瘤的临床病理特征。方法通过报告在本院诊治的1例乙状结肠系膜多形性脂肪肉瘤患者的诊治经过并检索中英文数据库中相关文献,分析连同本例共12例结肠系膜脂肪肉瘤的临床病理特征、治疗和预后。结果结肠系膜脂肪肉瘤的中位发病年龄为49岁;其中男性7例(58.3%),女性5例(41.7%);肿瘤直径介于2~50 cm;6例(50.0%)肿瘤位于乙状结肠或乙-直交界系膜,3例(25.0%)位于右半结肠系膜,横结肠系膜2例(16.7%),降结肠系膜1例(8.3%)。高分化脂肪肉瘤4例(33.3%),粘液性脂肪肉瘤3例(25.0%),去分化脂肪肉瘤1例(8.3%),多形性脂肪肉瘤1例(8.3%),1例多原发脂肪肉瘤具有两种不同病理类型,未描述病理类型的2例。术后9例患者有随访资料,中位随访17.5月,3例复发(33.3%),其中2例为黏液性脂肪肉瘤。结论乙状结肠系膜多形性脂肪肉瘤罕见,预后不良。外科完整切除是其主要的治疗手段。肿瘤体积和是否达到安全切缘的完整切除是影响预后的主要因素。Objective To investigate the clinicopathological features of liposareoma of the mesocolon. Me/hods A patient of sigmoid mesocolon pleomorpbic liposarcoma was successfully treated in Pengpai Commemorative Hospital. By reviewing literature from both Chinese and English database, altogether 12 cases of mesocolon liposarcoma, with the present case, were reported. The clinicopathological features, treatment and prognosis of the 12 cases were analyzed. Results The median age of patients was 49 years. There were seven males （58.3%） and five females （41.7%）. The tumor diameter ranged from 2-50 cm. In six cases （50%） the tumors were located in the sigmoid or sigmoidorectal mesocolon, three （25%） in the right mesocolon, two （16.7%） in transverse mesocolon, one （8.3%） in the descending mesocolon. In terms of pathology, four （33.3%） cases were well-defferentiated, three （25%） were mutinous, one （8.3%） was dedifferentiated, one （ 8.3% ） was pleomorphic, one （ 8.3% ） was multiple origin liposarcoma with two different pathological types and two with unspecified pathological subtypes. Follow-up data were available in nine patients. The median follow-up period was 17.5 months. RecmTence was recorded in three cases （33.3%）, of which two cases were mueinous liposarcoma. Conclusion Sigmoid mesocolon pleomorphic liposarcoma is rare and of unfavorable prognosis. Complete resection is the main treatment approach. Tumor size and complete resection with clear margin are the main factors predicting prognosis.

关 键 词：脂肪肉瘤 结肠系膜 手术 

分 类 号：R735.3[医药卫生—肿瘤]