反覆復發之巨大縱膈脂肪肉瘤

Repeated Recurrences of Giant Mediastinal Liposarcoma

一位72歲男性病人，為了縱膈巨大脂肪肉瘤及其復發，前後接受了四次切除手術。55歲時，他接受了右側開胸術和左頸切開，切除巨大的脂肪肉瘤。67歲時，他接受了第二次開胸手術，切除復發縱膈脂肪肉瘤。手術標本也被證明是高分化脂肪肉瘤的復發。71歲時，他接受了第三次手術，採用胸骨切開術和左前胸切開術切除復發的脂肪肉瘤。手術標本被證明是高分化和去分化脂肪肉瘤的復發。72歲時，他接受了第四次手術，右側胸廓切開術，切除復發侵及食道的脂肪肉瘤，並修補多處破洞之食道。手術標本也是高分化和去分化脂肪肉瘤的復發。病人在最後一次手術後已四個月，情況良好，並已接受輔助化療。

A 72-year-old male patient underwent four surgical resections for giant mediastinal liposarcoma over 17 years. At the age of 55, he first underwent a right thoracotomy with a left neck incision for the resection of a giant mediastinal liposarcoma. At the age of 67, he underwent a second right thoracotomy with resection of recurrent mediastinal liposarcoma. At the age of 71, he underwent surgery a third time using sternotomy and left anterior extension for resection of the recurrent mediastinal liposarcoma, which extended to the left thorax. The operative specimens were a recurrence of well-differentiated and de-differentiated liposarcoma. At the age of 72, he underwent a fourth surgery using right thoracotomy for the resection of recurrent mediastinal lipoma, which invaded the esophagus, and repair of the multiple esophageal defects. The operative specimens were composed of recurrent well-differentiated to de-differentiated liposarcoma. The patient was well four months after the last operation and has received adjuvant chemotherapy.