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Primary colonic well-differentiated?/?dedifferentiated liposarcoma of the ascending colon: a case report

机译:升结肠的原发性结肠高分化?/?去分化脂肪肉瘤:一例报告

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BackgroundPrimary colonic and dedifferentiated liposarcomas are both remarkably rare. This work describes a case of primary colonic well-differentiated/dedifferentiated liposarcoma and reviews the clinical characteristics and current therapies for liposarcoma tumors. Case presentationA 52-year-old woman was referred to our hospital with a submucosal tumor of the ascending colon. Clinical analysis by ultrasound colonoscopy and computed tomography revealed a partially ossified tumor with irregular edges continuous with the muscular layer. High F-18 deoxyglucose uptake was detected by positron emission tomography. Radical resection with lymph node dissection was performed, yielding a tumor specimen approximately 6.5?×?4.0?×?3.2?cm. Neoplastic spindle cell proliferation was found from submucosa to subserosa. Well-differentiated adipose tissue surrounded the tumor, but contained atypical nuclei with condensed chromosomes. Immunohistochemical staining was positive for p16, CDK4, and MDM2 expression. Based on these findings, a diagnosis of well-differentiated/dedifferentiated liposarcoma was given. Dedifferentiated liposarcomas are more aggressive than their well-differentiated, low-grade counterparts. While local recurrence can occur with both tumor types, dedifferentiated liposarcomas are more prone to developing distant metastases. The patient received no postoperative therapy, and no recurrences have been observed 12?months after surgery. ConclusionsHere we report an extremely rare case of well-differentiated/dedifferentiated liposarcoma of the ascending colon. The dedifferentiated component was high-grade liposarcoma and well-differentiated liposarcoma was detected around the main tumor.
机译:背景原发性结肠和去分化的脂肪肉瘤均极为罕见。这项工作描述了原发性结肠高分化/去分化脂肪肉瘤的情况,并回顾了脂肪肉瘤肿瘤的临床特征和当前疗法。病例介绍一名52岁妇女因结肠上升粘膜下肿瘤被转诊至我院。通过超声结肠镜检查和计算机断层扫描进行的临床分析显示,部分骨化的肿瘤具有不规则的边缘,并与肌肉层相连。通过正电子发射断层扫描检测到高F-18脱氧葡萄糖摄取。进行根治性切除和淋巴结清扫术,得到的肿瘤标本约为6.5?×?4.0?×?3.2?cm。发现从粘膜下层到浆膜下层的肿瘤梭形细胞增殖。分化良好的脂肪组织围绕着肿瘤,但包含具有浓缩染色体的非典型核。免疫组织化学染色显示p16,CDK4和MDM2表达阳性。基于这些发现,诊断为高度分化/去分化的脂肪肉瘤。去分化的脂肪肉瘤比分化良好的低级脂肪肉瘤更具侵略性。虽然两种类型的肿瘤都可能发生局部复发,但去分化的脂肪肉瘤更容易发生远处转移。该患者未接受术后治疗,且术后12个月未观察到复发。结论在此我们报道了极为罕见的升结肠脂肪肉瘤高度分化/去分化的病例。去分化成分是高度脂肪肉瘤,在主要肿瘤周围检测到分化良好的脂肪肉瘤。

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