後腹膜肉腫の3例

Abstract

後腹膜原発の軟部組織肉腫3例を報告した.症例1は30歳男性, 症例2は31歳女性で, 左胸痛, 腹部膨満感を自覚した.CTで腫瘍を認め, 腫瘍摘出術を行った.腫瘍と左腎, 脾臓との癒着は強固であった.摘除標本の重量は症例1:3000g, 症例2:2000gで, 病理組織学的に後腹膜原発のfibrosarcoma, undifferential sarcomaと診断された.2例とも腫瘍断端陽性を一部に認め, その後再発した.症例1は再腫瘍摘出術を行ったが, 初回手術から約1年半後に, 症例2は術後約2ヵ月半後に死亡した.尚, 症例1は, 再腫瘍摘出術の病理組織像も原発巣と同様であった.症例3は73歳女性で, 心不全フォロー中に腫瘍を指摘され, 腫瘍摘出術を行った.重量は2420gで, 病理組織学的にwell-differentiated liposarcomaが一部で脱分化したものと診断された.一部に腫瘍細胞を認めた.術後1年2ヵ月後に局所再発が出現し, 2回目の腫瘍摘除術を行った.病理組織診断は初回同様differentiated liposarcomaであった

Soft tissue sarcomas (STS) are rare tumors that comprise only 1% of all malignancies. The retroperitoneum is an uncommon site of origin for them, accounting for about 10% of all STS. In case 1, a 30-year-old man complaining of chest pain was found to have a retroperitoneal tumor around the left kidney by computed tomography (CT). The tumor was removed along with the left kidney. Histologically, it was fibrosarcoma 3, 000 g in weight. In case 2, a 31-year-old woman complaining of abdominal distension was found to have a retroperitoneal tumor by CT. The tumor was removed in the same way. It was undifferentiated sarcoma 2, 000 g in weight. In case 3, a 73-year-old woman, who had no complaint was found to have mass in the left lateral region during follow up for cardiac failure. She was referred to our department for treatment of retroperitoneal tumor revealed by ultrasound and CT. The tumor was dedifferentiated liposarcoma 2, 420 g in weight. All three patients had local recurrences, and two of them underwent a second surgical procedure.