论文信息 - A case of a posterior mediastinal well-differentiated liposarcoma which recurred with dedifferentiation 11 years later

A case of a posterior mediastinal well-differentiated liposarcoma which recurred with dedifferentiation 11 years later

症例は82歳, 男性.1988年8月, 後縦隔脂肪肉腫 (高分化型) にて当科で腫瘍摘出術を施行した.1999年10月, 胸部単純写真にて異常陰影を認め, 縦隔脂肪肉腫再発と診断され, 当科に紹介された.胸部CTでは上部後縦隔の食道背側と下部後縦隔の椎体前面に, それぞれ8×5×4cm, 8×6×4cmの内部が脂肪組織と同程度の濃度からなる腫瘤を認め, その周囲に径3cmの石灰化を伴う腫瘤を2個認めた.同年12月15日, 右後側方開胸下に腫瘍を摘出した.病理組織学的に主腫瘤は脱分化を伴う高分化型脂肪肉腫で, 小腫瘤は軟骨成分であった.高分化型脂肪肉腫に悪性線維性組織球腫などの高悪性度の肉腫像を示す脱分化部分を伴うものは, 脱分化型脂肪肉腫と呼ばれ, 予後不良とされている.本症例のように高分化型脂肪肉腫が長期間経過後に脱分化を伴って局所再発する例もあり, 長期にわたる厳重な経過観察が必要と考えられた.

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