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A rare case of primary small bowel de-differentiated liposarcoma causing intussusception: A case report

机译:罕见的原发性小肠去分化脂肪肉瘤引起肠套叠的罕见病例:一例报告

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Rationale: Liposarcoma (LPS) is a relatively rare malignant soft tissue tumor. Management of LPS including diagnosis is difficult, because it has no characteristic symptoms and no established effective treatment. Herein we reported an extremely rare case of intussusception induced by primary small bowel LPS. Patient's concern: A-84-year-old male was a consult to our Emergency Department with symptoms of a terrible general fatigue, abdominal pain, and vomiting. Diagnosis: Abdominal ultrasonography and computed tomography (CT) revealed probable intussusception . Interventions: After decompression by insertion of an ileus tube, surgery was performed. Outcomes: The ileum and mesentery of the small intestine had invaginated into the colon. There was no evidence of metastases in the intraabdominal space. The Hutchinson maneuver could not release the invagination, and so ileocecal resection with lymph node dissection was performed. Histopathological examination showed evidence of the growth of spindle-shaped cells. Also, immunohistochemical examination indicated the tumor to be a de-differentiated LPS. The patient was discharged on postoperative day 19 without any complications; and no recurrence of the tumor was observed at 16 months post operation. Lessons: LPS should be considered in the differential diagnosis of adult intussusception , and careful management should be required, including observation, after surgery.
机译:理由:脂肪肉瘤(LPS)是一种相对罕见的恶性软组织肿瘤。 LPS的管理包括诊断很困难,因为它没有特征性症状,也没有既定的有效治疗方法。本文中,我们报道了由原发性小肠LPS引起的肠套叠的极少数病例。患者关注的问题:一位A-84岁男性曾就诊于我们的急诊科,伴有严重的全身疲劳,腹痛和呕吐症状。诊断:腹部超声和计算机断层扫描(CT)显示可能存在肠套叠。干预措施:通过插入肠梗阻减压后,进行手术。结果:小肠的回肠和肠系膜已渗入结肠。没有证据显示腹腔内有转移。 Hutchinson操作无法释放内翻,因此进行了回盲肠切除并淋巴结清扫术。组织病理学检查显示纺锤形细胞生长的证据。同样,免疫组织化学检查表明肿瘤是去分化的LPS。患者于术后第19天出院,无任何并发症。术后16个月未见肿瘤复发。经验教训:在成人肠套叠的鉴别诊断中应考虑LPS,并且在手术后应进行仔细的处理,包括观察。

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