胫骨近端伴血管肉瘤去分化的脂肪肉瘤1例

Dedifferentiated liposarcoma in proximal tibia accompanied by angiosarcoma: One case report

报告1例胫骨近端伴有血管肉瘤去分化的脂肪肉瘤,并通过分析其影像学、临床、病理等方面特点,进一步认识去分化脂肪肉瘤。2007-05在本院诊治的1例患者,男,51岁,因"发现左胫骨近端占位6d,骨肿瘤可能"收入院。回顾性分析其各项临床特点,包括起病特点、体格检查、血常规、影像学改变、病理特点、手术方式、随访时间。行肿瘤刮除灭活,髂骨植骨,骨水泥填充,胫骨平台T型钢板螺钉内固定+肿瘤组织活检术,术后40d肿瘤复发。再次入院行患肢截肢术,术后2周患者出现咯血,多脏器功能衰竭死亡。血管肉瘤去分化的脂肪肉瘤在影像学、临床表现、实验室检查等方面无明显特点,诊断有一定困难。肿瘤恶性程度高,起病快,病程短,预后不良。

One case with dedifferentiated liposarcoma in proximal tibia accompanied by angiosarcoma was analyzed. The dedifferentiated liposarcoma was further analyzed by imaging, clinical and pathological features. One 51-year-old male patient was suspected to bone tumor due to space occupying lesion for 6 days in left proximal tibia and admitted in Changhai Hospital of Second Military Medical University of Chinese PLA in May 2007. The clinical features, including onset features, physical examination, blood routine, imaging alterations, pathological characteristics, operation approach, and follow-up period were retrospectively analyzed. The tumor was treated by curettage and inactivation, iliac grafting, bone cement filling, tibial plateau T type plate and screw internal fixation and tumor tissue biopsy. However, tumor relapsed 40 days postoperatively, and the patient was treated by amputation surgery. Two weeks after surgery, the patient developed emptysis and died due to multiple organ failure. Dedifferentiated liposarcoma accompanied by angiosarcoma displays no noticeable characteristics in imaging, clinical manifestation, and laboratory examination, which make it difficult to diagnose it. This tumor is highly malignant, and has short disease course, and poor prognosis.