内容紹介
Summary
A 71-year-old woman visited our hospital for the examination and treatment of retroperitoneal tumor. CT showed a retroperitoneal tumor extending to the posterior mediastinum; the tumor pressed the IVC and widely abutted the aorta. On MRI, the tumor showed low intensity on T1WI and high intensity on T2WI and DWI. However, the tumor did not show signal reduction on an ADC map. PET-CT showed high accumulation at the tumor. The patient was diagnosed with sarcoma arising from the retroperitoneum. The tumor located on a part of the diaphragm was resected. Histological examination revealed spindle cells with atypical nuclear and multinuclear cells. There were no lesions of well-differentiated liposarcoma. Both CDK4 and MDM2 tested positive on immunohistological staining. Histopathologically, the tumor was diagnosed as dedifferentiated liposarcoma without any well-differentiated liposarcoma component. The postoperative course was uneventful, and she was discharged on the 13th day after surgery. Two months after surgery, no recurrence has been detected.
要旨
症例は71歳,女性。不安神経症,高血圧で近医通院中に肝機能異常を認め,CTで後縦隔腫瘤を指摘され当院に紹介となった。CTでは後縦隔から後腹膜にかけて,11×9.5 cm大の境界明瞭な低濃度腫瘍を認め,造影では内部は不均一に淡く造影された。腫瘍は肝を背側から圧排し,左腎静脈合流部頭側の下大静脈は扁平化しており,また大動脈右半周と広く接していたMRIではT1WI低信号,T2WI高信号で,ADC mapでは拡散低下は認められなかった。PET-CTでは腫瘍はSUVmax 10.84の高い集積を示した。後縦隔から後腹膜原発の軟部組織腫瘍と診断し横隔膜合併腫瘤摘出手術を施行した。摘出標本では充実性,淡黄色調の軟らかい腫瘍で,病理組織学的には多形,多核の異型細胞を混じた紡錘形細胞が増殖していた。高分化型脂肪肉腫成分は確認できなかったが,免疫染色ではCDK4(+),MDM2(+)であり,最終的には脱分化型脂肪肉腫と診断された。術後13日目に退院,術後2か月の現在,外来で経過観察中である。
目次
A 71-year-old woman visited our hospital for the examination and treatment of retroperitoneal tumor. CT showed a retroperitoneal tumor extending to the posterior mediastinum; the tumor pressed the IVC and widely abutted the aorta. On MRI, the tumor showed low intensity on T1WI and high intensity on T2WI and DWI. However, the tumor did not show signal reduction on an ADC map. PET-CT showed high accumulation at the tumor. The patient was diagnosed with sarcoma arising from the retroperitoneum. The tumor located on a part of the diaphragm was resected. Histological examination revealed spindle cells with atypical nuclear and multinuclear cells. There were no lesions of well-differentiated liposarcoma. Both CDK4 and MDM2 tested positive on immunohistological staining. Histopathologically, the tumor was diagnosed as dedifferentiated liposarcoma without any well-differentiated liposarcoma component. The postoperative course was uneventful, and she was discharged on the 13th day after surgery. Two months after surgery, no recurrence has been detected.
要旨
症例は71歳,女性。不安神経症,高血圧で近医通院中に肝機能異常を認め,CTで後縦隔腫瘤を指摘され当院に紹介となった。CTでは後縦隔から後腹膜にかけて,11×9.5 cm大の境界明瞭な低濃度腫瘍を認め,造影では内部は不均一に淡く造影された。腫瘍は肝を背側から圧排し,左腎静脈合流部頭側の下大静脈は扁平化しており,また大動脈右半周と広く接していたMRIではT1WI低信号,T2WI高信号で,ADC mapでは拡散低下は認められなかった。PET-CTでは腫瘍はSUVmax 10.84の高い集積を示した。後縦隔から後腹膜原発の軟部組織腫瘍と診断し横隔膜合併腫瘤摘出手術を施行した。摘出標本では充実性,淡黄色調の軟らかい腫瘍で,病理組織学的には多形,多核の異型細胞を混じた紡錘形細胞が増殖していた。高分化型脂肪肉腫成分は確認できなかったが,免疫染色ではCDK4(+),MDM2(+)であり,最終的には脱分化型脂肪肉腫と診断された。術後13日目に退院,術後2か月の現在,外来で経過観察中である。