復發性脂肪瘤

Recurrent Liposarcoma

一位74歲男性，一年前發現右大腿背側有一約拳頭大小的脂肪瘤，經手術切除。經過一年，原處再度發現有一腫塊，經由電腦斷層攝影掃瞄，估測其大小約為40×10×5 cm，自大臀肌延伸至股二頭肌半部，並包住坐股神經。經由手術切除，並進行照射治療與化學治療；坐股神經則被完整保留。病理報告診斷為Ⅱ A中度分化黏液性惡性脂肪瘤。由此病例的經歷中。我們認為最好的處理方法，應該是外科手術加上放射線治療與化學治療，以預防脂肪瘤的復發。

A 74 years old male patient visited one OPD with a soft tissue mass in the posterior aspect of the right thigh, although he had received a removal procedure in the same site in the other hospital. The mass was found to be 40×10×5cm in size on computed tomography (CT), extending form the inferior margin of the gluteus maximus muscle to the middle of the biceps femoris, with the sciatic nerve located at the central portion of the mass. At surgery, the nerve was well preserved. And postoperaive radiotherapy and chemotherapy followed. After the surgical removal, the mass proved to be moderately differentiated myxoid type of liposarcoma pathologically. In conclusion, basing the experience of the above case, We strongly suggest that a complete surgical removal followed by intensive radiotherapy and chemotherapy is mandatory for a soft tissue liposarcoma to prevent recurrence.