超声引导下放射性^(125)I粒子植入治疗转移性腹膜后去分化脂肪肉瘤1例

Ultrasound-guided^(125)I radioactive seed implantation for metastatic retroperitoneal dedifferentiated liposarcoma:a case report

去分化脂肪肉瘤(DDLPS)是一种罕见的脂肪肉瘤亚型,预后不良。本病例报告描述了1例65岁中国女性的肝脏及腹膜后DDLPS,临床表现为无痛性腹部肿物。进行计算机断层扫描和超声检查发现瘤体较大且出现部分脏器转移,遂行腹膜后巨大肿瘤切除术及肝部分切除术。术后肿瘤免疫组织化学表现为S-100(+),SOX10(-),Desmin(+)。患者愈合良好,为控制转移病灶,术后三个月行超声引导下右侧腹膜后(肝肾间隙)肿瘤放射性^(125)I粒子植入治疗。通过粒子放射治疗,达到稳定病情的治疗目标。本病例报告对该患者的治疗及病例资料进行分析,从DDLPS的临床诊断、治疗和病理特点等方面对文献进行综述,以期提高诊疗水平。

Dedifferentiated liposarcoma(DDLPS)is a rare subtype of liposarcoma with poor prognosis.This case report describes a 65-year-old Chinese woman with liver and retroperitoneal DDLPS,clinically manifested with painless abdominal masses.The computed tomography and ultrasound showed large tumor and partial organ metastasis,and therefore,the retroperitoneal giant tumor resection and partial hepatectomy were performed.Postoperative immunohistochemical manifestations of tumor were S-100(+),SOX10(-)and Desmin(+).The patient was healed well.In order to control the metastatic lesions,the ultrasound-guided^(125)I radioactive seed implantation for right retroperitoneal tumor(liver-kidney space)was performed three months after operation.Through seed radiotherapy,the treatment goal of stable condition was achieved.This case report analyzes the treatment and case data of this patient,and also summarizes the literature from the aspects of clinical diagnosis,treatment and pathological characteristics of DDLPS,in order t o improve the level of diagnosis and treatment.