Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 126
Filtrar
1.
Rev. Bras. Cancerol. (Online) ; 69(3)jul-set. 2023.
Artigo em Português | LILACS, Sec. Est. Saúde SP | ID: biblio-1512820

RESUMO

Introdução: Os lipossarcomas são tumores malignos raros de origem mesenquimal, a partir de precursores de adipócitos, podendo ocorrer no retroperitônio. Os lipossarcomas retroperitoneais representam de 0,3% a 0,6% das neoplasias malignas. Em virtude do crescimento lento e assintomático do tumor, tendo como principal manifestação clínica o aumento do volume abdominal, o quadro é comumente acompanhado de um diagnóstico tardio e curso indolente. Relato do caso: Homem, 70 anos de idade, com aumento progressivo abdominal há cerca de dois anos. A ressonância magnética demonstrou uma formação em topografia retroperitoneal à direita, promovendo importante desvio das estruturas da linha média, com presença de conteúdo sólido acima da estrutura supradescrita. Foi submetido à laparotomia xifopúbica, com apresentação de massa gigante retroperitoneal que ocupava todo abdome, com deslocamento das alças intestinais e rim direito. Foram realizadas ressecção do tumor em bloco, rafia diafragmática e colecistectomia. Após três meses do primeiro procedimento cirúrgico, o paciente apresentou novamente aumento do volume abdominal, com confirmação de recidiva tumoral após realização de exames de imagem. Um novo procedimento cirúrgico foi realizado, revelando tumor com cápsula rompida e múltiplos coágulos. Após alta hospitalar, foi submetido a sessões de radioterapia complementares à cirurgia. Conclusão: A rápida reapresentação do paciente após o surgimento da recidiva, comum nesses casos, foi essencial para a redução de resíduos na segunda cirurgia, evidenciando a importância de exames periódicos para o reconhecimento precoce da recorrência local. No presente caso, também foram realizadas sessões de radioterapia, com a finalidade de evitar a recidiva, sem sucesso.


Introduction: Liposarcomas are rare malignant tumors of mesenchymal origin, from adipocyte precursors, which may occur in the retroperitoneum. Retroperitoneal liposarcomas account for 0.3% to 0.6% of malignant neoplasms and the main symptom is increased abdominal volume. Due to the slow and asymptomatic growth of the tumor, the condition is commonly associated with late diagnosis and indolent course. Case report: 70-year-old man with progressive abdominal enlargement for about two years. Magnetic resonance imaging demonstrated a formation in the right retroperitoneal topography, promoting significant deviation of the midline structures. Furthermore, there was a solid content above the structure described above. A xiphopubic laparotomy was performed with presentation of giant retroperitoneal mass occupying the entire abdomen, displacing the intestinal loops and the right kidney. En bloc tumor resection, diaphragmatic raffia and cholecystectomy were performed. Three months after the first surgical procedure, the patient presented a novel increase of the abdominal volume which imaging tests showed tumor recurrence. A new surgical procedure was performed, revealing a tumor with a ruptured capsule and multiple clots. After hospital discharge, the patient was submitted to complementary radiotherapy Conclusion: The fast return of the patient after the recurrence, common in these cases, was essential to reduce the residues of the second surgery, highlighting the importance of periodic examinations for the early recognition of local recurrence. In this case, radiotherapy sessions were also performed to prevent recurrence, however, unsuccessful.


Introducción: Los liposarcomas son tumores malignos raros de origen mesenquimatoso, a partir de precursores de los adipocitos, y pueden presentarse en el retroperitoneo. Los liposarcomas retroperitoneales representan del 0,3% al 0,6% de las neoplasias malignas, siendo el síntoma principal el aumento de volumen abdominal. Debido al crecimiento lento y asintomático del tumor, la condición se acompaña comúnmente de un diagnóstico tardío y un curso indolente. Informe del caso: Varón, 70 años, con agrandamiento abdominal progresivo de unos 2 años de evolución. La resonancia magnética nuclear mostró una formación en la topografía retroperitoneal hacia la derecha, promoviendo una desviación significativa de las estructuras de la línea media. Además, se observó un contenido sólido por encima de la estructura descrita anteriormente. Considerando la principal hipótesis diagnóstica, liposarcoma de retroperitoneo, se realizó laparotomía, evidenciándose una masa retroperitoneal gigante que ocupaba todo el abdomen, que desplazaba las asas intestinales y el riñón derecho. Se realizó disección y resección del tumor en bloque para extirpar la masa tumoral, así como rafia diafragmática y colecistectomía. A los tres meses del primer acto quirúrgico, el paciente volvió a presentar aumento de volumen abdominal, en el que las pruebas de imagen mostraron recidiva tumoral. Se realizó un nuevo procedimiento quirúrgico que reveló un tumor con una cápsula rota y múltiples coágulos. Conclusión: El rápido retorno del paciente tras el inicio de la recidiva, frecuente en estos casos, fue fundamental para reducir los residuos en la segunda cirugía, destacando la importancia de las exploraciones periódicas para el reconocimiento precoz de la recidiva local. En este caso también se realizaron sesiones de radioterapia, con el objetivo de prevenir la recurrencia, sin éxito.


Assuntos
Espaço Retroperitoneal , Laparotomia , Lipossarcoma
2.
Rev. Bras. Cancerol. (Online) ; 69(3)jul-set. 2023.
Artigo em Espanhol, Português | LILACS, Sec. Est. Saúde SP | ID: biblio-1512840

RESUMO

Introdução: Os lipossarcomas retroperitoneais são neoplasias mesenquimais raras, sendo mais comuns os bem diferenciados e os desdiferenciados. O subtipo bem diferenciado pode sofrer desdiferenciação para tumores de maior grau. São neoplasias difíceis de tratar cirurgicamente, pois apresentam altas taxas de recorrência local, alguns subtipos podem metastizar e são pouco sensíveis à radioterapia e à quimioterapia. Relato do caso: Paciente feminina, 45 anos, apresentou dor abdominal e massa abdominal palpável em 2017. Foi submetida à ressecção de lipossarcoma bem diferenciado de retroperitônio, sem intercorrências. Em 2020, manifestou dor abdominal e perda ponderal. A tomografia mostrou múltiplas massas volumosas abdominais, com biópsia sugestiva de lipossarcoma desdiferenciado. Foi submetida à radioterapia neoadjuvante e, em seguida, à ressecção cirúrgica das massas e ileocolectomia direita. Em 2022, apresentou quadro sugestivo de obstrução intestinal, sendo submetida à laparotomia que evidenciou intenso bloqueio de alças intestinais, fístula duodenal, tumor retroperitonial e peritonite fecal. Procedeu-se à ressecção de neoplasia retroperitoneal, ileostomia e rafia de fístula. O histopatológico mostrou lipossarcoma desdiferenciado recidivado. A paciente evoluiu com complicações operatórias e infecciosas, necessitando de cuidados intensivos e antibioticoterapia. Após melhora clínica, recebeu alta com dieta enteral e segue em acompanhamento ambulatorial. Conclusão: O lipossarcoma de retroperitônio pode sofrer desdiferenciação, recidivas multifocais e múltiplas recorrências, necessitando de várias abordagens cirúrgicas, o que aumenta a morbidade e o risco de complicações. A cirurgia com margens amplas continua sendo a principal modalidade terapêutica.


ABSTRACT Introduction: Retroperitoneal liposarcomas are rare mesenchymal neoplasms, with well-differentiated and dedifferentiated liposarcomas being most common. The well differentiated subtype can undergo dedifferentiation to higher grade tumors. These are difficult neoplasms to treat surgically because they have high rates of local recurrence, some subtypes can metastasize, and are poorly responsive to radiotherapy and chemotherapy. Case report: Female patient, 45 years old, presented abdominal pain and palpable abdominal mass in 2017. She underwent resection of well-differentiated liposarcoma of the retroperitoneum, without intercurrences. In 2020, she manifested abdominal pain and weight loss. Tomography showed multiple voluminous abdominal masses, with biopsy suggestive of dedifferentiated liposarcoma. The patient was submitted to neoadjuvant radiotherapy, followed by surgical resection of the masses and right ileocolectomy. In 2022, she presented symptoms suggestive of intestinal obstruction, and underwent laparotomy that revealed intense blockage of intestinal loops, duodenal fistula, retroperitoneal tumor, and fecal peritonitis. Retroperitoneal neoplasm resection, ileostomy and fistula closure were performed. Histopathology showed relapsed dedifferentiated liposarcoma. The patient evolved with operative and infectious complications, requiring intensive care and antibiotic therapy. After clinical improvement, the patient was discharged with enteral diet and continues under outpatient follow-up. Conclusion: Retroperitoneal liposarcoma may undergo multifocal dedifferentiation and recurrence, requiring several surgical approaches, increasing morbidity and the risk of complications. Wide margin surgery remains the main therapeutic modality.


Introducción: Los liposarcomas retroperitoneales son neoplasias mesenquimatosas raras, siendo los más comunes los liposarcomas bien diferenciados y desdiferenciados. El subtipo bien diferenciado puede sufrir desdiferenciación hacia tumores de mayor grado. Estas neoplasias son difíciles de tratar quirúrgicamente porque presentan altas tasas de recidiva local, algunos subtipos pueden hacer metástasis y responden mal a la radioterapia y la quimioterapia. Informe del caso: Mujer de 45 años, en 2017 presenta dolor abdominal y masa abdominal palpable. Fue sometida a la resección de un liposarcoma bien diferenciado del retroperitoneo, sin intercurrencias. En 2020, manifestó dolor abdominal y pérdida de peso. La tomografía mostró múltiples masas abdominales voluminosas, con biopsia sugestiva de liposarcoma desdiferenciado. Fue sometida a radioterapia neoadyuvante y luego a resección quirúrgica de las masas y a ileocolectomía derecha. En 2022, presentó síntomas de obstrucción intestinal y fue sometida a una laparotomía que reveló obstrucción de las asas intestinales, fístula duodenal, tumor retroperitoneal y peritonitis fecal. Se realizó la resección de la neoplasia retroperitoneal, la ileostomía y la fistulización. La histopatología mostró un liposarcoma desdiferenciado. La paciente evolucionó con complicaciones operatorias e infecciosas, requiriendo cuidados intensivos y terapia antibiótica. Tras la mejora clínica, la paciente fue dada de alta con dieta enteral y está en seguimiento. Conclusión: El liposarcoma retroperitoneal puede sufrir desdiferenciación multifocal y recurrencia, requiriendo varios a tratamientos quirúrgicos, aumentando la morbilidad y el riesgo de complicaciones. La cirugía con márgenes amplios sigue siendo la terapia principal.


Assuntos
Recidiva , Neoplasias Retroperitoneais , Desdiferenciação Celular , Oncologia Cirúrgica , Lipossarcoma
4.
Autops. Case Rep ; 11: e2020224, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1142411

RESUMO

Retroperitoneal liposarcomas are rare tumors arising from the soft tissue of the retroperitoneum and are of mesenchymal cell origin. They can reach a large size prior to causing symptoms and generally have a poor prognosis. We present the case of a 93-year-old lady presenting with a large retroperitoneal liposarcoma at the site of a previous colonic anastomosis for the adenocarcinoma treatment. It caused minimal symptoms initially, but surgical resection was undertaken when the tumor was found to be growing significantly in size. However, due to the tumor's location and its invasion into surrounding structures, the resection was not feasible and subsequently abandoned. A retroperitoneal liposarcoma arising from the site of a previous colonic resection has not been previously described. A review of the diagnosis and current management of these lesions is also given.


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias Retroperitoneais/patologia , Neoplasias do Colo , Lipossarcoma/patologia , Cirurgia Colorretal
5.
Autops. Case Rep ; 10(1): 2020137, Jan.-Mar. 2020. ilus
Artigo em Inglês | LILACS | ID: biblio-1087663

RESUMO

Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula's tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient's full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.


Assuntos
Humanos , Feminino , Idoso , Actinomicose/diagnóstico , Abdome/anormalidades , Lipossarcoma/diagnóstico , Diagnóstico Diferencial
7.
Gac. méd. boliv ; 42(2): 168-171, dic. 2019. ilus.
Artigo em Espanhol | LILACS | ID: biblio-1293187

RESUMO

Los sarcomas de tejidos blandos son raros y representan menos del 1% de las neoplasias malignas recién diagnosticadas. La rareza de los tumores retroperitoneales, combinada con las variedades de subtipos histológicos, ha complicado los conocimientos sobre estos e impedido el desarrollo de terapia efectivas. Los liposarcomas retroperitoneales crecen lenta y silenciosamente, su pronóstico es malo y el tratamiento de elección es la resección quirúrgica. Se expone el caso de paciente femenino de 50 años de edad con el diagnóstico de ingreso de tumor abdominal, operada hace 39 meses por la misma causa, refiriendo liposarcoma tipo mixoide grado II, se realizó una laparotomía y se identificó masa tumoral retroperitoneal gigante con un peso de 6 100 gr. y se establece el diagnostico de tumor lipomatoso atipico/ liposarcoma bien diferenciado. Se informa este caso por la rareza de su conformación y la ausencia de reportes en la literatura nacional, con escasas patologías de similares características de presentación a nivel mundial.(AU)


Soft tissue sarcomas are rare and represent less than 1% of newly diagnosed malignancies. The rarity of retroperitoneal tumors, combined with the varieties of histological subtypes, has complicated the knowledge about these and impeded the development of effective therapy. Retroperitoneal liposarcomas grow slowly and silently, their prognosis is bad and the treatment of choice is surgical resection. We present the case of a female patient of 50 year old with a diagnosis of admission of an abdominal tumor, operated 39 months ago for the same cause, referring grade II myxoid-type liposarcoma, a laparotomy was performed and a giant retroperitoneal tumor was identified a weight of 6 100 gr. and the diagnosis of atypical lipomatous tumor / well differentiated liposarcoma is established. This case is reported due to the rarity of its conformation, the absence of reports in the national literature with few pathologies of similar presentation characteristics worldwide.(AU)


Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Neoplasias de Tecidos Moles
9.
Rev. cir. (Impr.) ; 71(2): 157-161, abr. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1058249

RESUMO

INTRODUCCIÓN: Los tumores paratesticulares representan del 7%-10% de las masas intraescrotales. Los sarcomas abarcan el 90% de las lesiones malignas del cordón espermático y de éstas, aproximadamente, el 3%-7% son liposarcomas. CASO CLÍNICO: Presentamos el caso de un varón de 45 años, que consultó en urgencias por una masa inguinoescrotal derecha no reductible, diagnosticándose de hernia inguinal incarcerada. Se realizó cirugía urgente evidenciando una gran tumoración de aspecto lipomatoso, dependiente de cordón espermático. Se realizó orquiectomía y hernioplastía inguinal. La anatomía patológica, reveló un liposarcoma bien diferenciado de cordón espermático. Posteriormente, se realizó estudio de extensión, sin afectación a distancia y no precisó tratamiento adyuvante. Actualmente, tras dos años de seguimiento no ha presentado recidiva. DISCUSIÓN: Sólo alrededor de 200 casos han sido comunicados previamente en la literatura y sólo 61 de éstos se presentaron simulando una hernia inguinal incarcerada. Debido a la baja incidencia de esta patología es difícil de conocer la historia natural y llegar a conclusiones sobre los resultados del tratamiento, el cual hasta el momento sigue siendo la orquiectomía radical, con escisión amplia de los tejidos locales. El papel de la radio y quimioterapia aun es controvertido. CONCLUSIONES: Los sarcomas del cordón espermático son neoplasias raras con alta tasa de recurrencia local. Su manejo inicial es quirúrgico. Se requiere de un alto índice de sospecha clínica para el diagnóstico ya que las implicaciones oncológicas varían en función del tratamiento que, en ocasiones, es llevado a cabo por cirujanos generales al simular una hernia inguinal.


INTRODUCTION: Paratesticular tumors represent 7%-10% of intraescrotal masses. Sarcomas account for 90% of malignant lesions of the spermatic cord and of these approximately 3%-7% are liposarcomas. CLINICAL CASE: This is the case of a 45 year old male who consulted in the emergency department for a non-reducible right inguino-scrotal mass and was diagnosed with an incarcerated inguinal hernia. Emergency surgery was performed which revealed a large lipomatous tumor, originating from the spermatic cord. Orchiectomy and hernioplasty were performed. Histopathology revealed a well-differentiated liposarcoma of the spermatic cord. Later extension study was conducted, without distant affectation, and did not require adjuvant treatment. Today, after two years of monitoring has been no recurrence. DISCUSSION: Only about 200 cases have been previously reported in the literature and only 61 of these were presented mimicking an incarcerated inguinal hernia. Due to the low incidence of this disease it is difficult to know the natural history and draw conclusions on the results of treatment, which so far remains the radical orchiectomy with wide local excision of the tissue. The role of radiotherapy and chemotherapy is still controversial


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Testiculares/cirurgia , Lipossarcoma/cirurgia , Cordão Espermático , Cordão Espermático/patologia , Neoplasias Testiculares/diagnóstico , Orquiectomia/métodos , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Hérnia Inguinal/cirurgia , Hérnia Inguinal/diagnóstico , Lipossarcoma/diagnóstico
10.
Autops. Case Rep ; 9(1): e2018056, Jan.-Mar. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-987165

RESUMO

The colon is a rare site of occurrence of liposarcoma, as either the primary site or by secondary involvement from a retroperitoneal liposarcoma. Liposarcomatosis denotes simultaneous occurrence of multiple liposarcomas. There are only 17 cases of primary colonic liposarcoma reported in the English literature­one of which was primary colonic liposarcomatosis. We depict the second case of primary colonic liposarcomatosis in a 57-year-old female who presented with abdominal swelling and pain. On exploratory laparotomy, two large masses were seen arising from the wall of the right colon along with multiple smaller masses attached to the colon. Right hemicolectomy with en bloc excision of the masses was performed along with hysterectomy and pelvic floor repair. Macroscopically, multiple exophytic masses and one endophytic mass were identified. The exophytic masses were of variable size and were found to hang from the colon by a thin pedicle simulating variable-sized appendices epiploicae. Histopathologically, the lesions showed the morphology of well-differentiated liposarcoma. This appears to be a case of primary colonic liposarcomatosis. There is only one other similar case reported in the English literature, to the best of our knowledge.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias do Colo/patologia , Lipossarcoma/patologia , Proteínas Proto-Oncogênicas c-mdm2/uso terapêutico
11.
Clin. biomed. res ; 39(3): 251-253, 2019.
Artigo em Português | LILACS | ID: biblio-1053130

RESUMO

O lipossarcoma de laringe é uma neoplasia extremamente rara, acomete principalmente o sexo masculino, principalmente na quinta década de vida. Existindo apenas cerca de 40 casos descritos na literatura, desses nenhum em língua portuguesa. O presente caso relata o diagnóstico em um paciente do sexo masculino, 57 anos, ex-tabagista, apresentando alteração de voz e obstrução de via área. Foi optado por ressecção cirúrgica completa com achados sugestivos de lipossarcoma bem diferenciado. Foi optado por manter seguimento, não tendo sido indicado quimioterapia e radioterapia adjuvantes.(AU)


Laryngeal liposarcoma is an extremely rare neoplasm that affects especially men in the fifth decade of life. There are only about 40 cases described in the literature, none of them in the Portuguese language. We report the case of a 57-year-old, former smoker man presenting with voice disorders and airway obstruction. We opted for complete surgical resection with findings suggestive of well-differentiated liposarcoma. We chose to keep following the patient, and no adjuvant chemotherapy and radiotherapy were indicated. (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Laríngeas/cirurgia , Lipossarcoma/cirurgia , Lipossarcoma/diagnóstico , Laringe/cirurgia , Pescoço/cirurgia
12.
urol. colomb. (Bogotá. En línea) ; 28(4): 330-332, 2019. ilus
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1402699

RESUMO

Introducción Los liposarcomas son lesiones que se originan en el tejido mesodérmico, su localización paratesticular es muy rara. Se divide en 4 subtipos histológicos, siendo el mixoide el más infrecuente. Tiene una recurrencia del 70%, Por lo que su tratamiento inicial debe ser agresivo. Objetivo resaltar su gran tamaño y que sea considerado como diagnóstico diferencial de masa inguinoescrotal. Presentación del caso Paciente masculino de 87 años con masa dolorosa inguinoescrotal derecha con diagnóstico de hernia inguinal unilateral, se realiza orquiectomía inguinal derecha. En patología se recibe pieza quirúrgica de 2440 g; al estudio histológico se observa lesión tumoral mesenquimal maligna, rodeado por estroma nodular mixoide prominente. Se diagnostica liposarcoma mixoide de cordón espermático. (Figura 2). Conclusiones Son neoplasias raras mal diagnosticadas como hernia inguinal, escrotal o lipoma de la médula espermática. Tiene un alto riesgo de metástasis, siendo la orquiectomía inguinal con resección del cordón espermático el manejo quirúrgico ideal.


Introduction Liposarcomas are lesions originated in the mesodermal tissue, paratesticular location is very rare. It is divided into 4 histological subtypes, being the most uncommon the myxoid. It has a recurrence of 70%, so the treatment should be aggressive. Objective to emphasize the large size and the differential diagnosis of inguinoescrotal mass. Case Presentation 87-year-old male patient with right inguinoescrotal pain with diagnosis of unilateral inguinal hernia, right inguinal orchiectomy is performed. A surgical specimen of 2440 g is received in pathology. Histological study shows malignant mesenchymal tumor lesion, surrounded by prominent myxoid nodular stroma. Myxoid liposarcoma of the spermatic cord is diagnosed. (Fig. 2). Conclusions they are rare neoplasms and are poorly diagnosed as inguinal hernia, scrotal or lipoma of the spermal cord. It has a high risk of metastasis, the ideal surgical management is an inguinal orchiectomy with resection of the spermatic cord.


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Cordão Espermático , Lipossarcoma Mixoide , Lipossarcoma , Terapêutica , Orquiectomia , Ficus , Diagnóstico Diferencial , Metástase Neoplásica
13.
Oncología (Guayaquil) ; 28(3): 232-240, 30 de Diciembre 2018.
Artigo em Espanhol | LILACS | ID: biblio-1000439

RESUMO

Introducción: De los tumores de retroperitóneo, el liposarcoma es considerado de crecimiento rápido y gran porcentaje de recurrencia, los autores lo consideran una patología inusual. Los sarcomas retroperitoneales son poco comunes constituyen el 10 a 15% de todos los sarcomas y su incidencia anual está estimada en 2.7 casos por millón de habitantes. Se decide realizar el presente estudio debido a ser patología inusual, siendo el objetivo principal la importancia del manejo quirúrgico de este tipo de tumores gigantes retroperitoneales. Métodos: Estudio descriptivo, retrospectivo, longitudinal, realizado en el Hospital Abel Gilbert Pontón desde enero 2013 a diciembre 2017. Se realiza revisión de historias clínica de todos los pacientes que acudieron a consulta externa presentando masa abdominal. Se seleccionan aquellos con diagnóstico anatomopatológico de liposarcoma retroperitoneal gigante, con datos completos en su historial y con mínimo 2 controles por consulta externa. Resultados: la muestra estudiada fue de 4 pacientes intervenidos quirúrgicamente entre 40 y 65 años. Tumores entre 45 a 70 cm, 1 caso con compromiso a órganos vecinos. No se reportaron complicaciones. Recibieron el alta en promedio a las 2 semanas de operados Conclusión: La serie de casos revisada evidencia que el manejo adecuado de este tipo de patologías, es multidisciplinario, siendo la piedra angular el tratamiento quirúrgico.


Introduction: Of the retroperitoneal tumors, the liposarcoma is considered of fast growth and great percentage of recurrence, the authors consider it an unusual pathology. Retroperitoneal sarcomas are uncommon, accounting for 10 to 15% of all sarcomas, and their annual incidence is estimated at 2.7 cases per million inhabitants. It was decided to perform the present study due to its unusual pathology, the main objective being the importance of the surgical management of this type of giant retroperitoneal tumors. Methods: A descriptive, retrospective, longitudinal study was carried out at the Abel Gilbert Pontón Hospital from January 2013 to December 2017. A review of the clinical histories of all the patients who attended the outpatient clinic presenting abdominal mass was performed. Those with anatomopathological diagnosis of giant retroperitoneal liposarcoma are selected, with complete data in their history and with at least 2 controls by external consultation. Results: the sample studied was of 4 patients surgically intervened between 40 and 65 years. Tumors between 45 to 70 cm, 1 case with commitment to neighboring organs. No complications were reported. They were discharged on average 2 weeks after surgery. Conclusion: The series of cases reviewed shows that the proper management of this type of pathologies is multidisciplinary, being the cornerstone the surgical treatment.


Assuntos
Humanos , Neoplasias Retroperitoneais , Espaço Retroperitoneal , Lipossarcoma , Sarcoma , Neoplasias Abdominais , Neoplasias
14.
Oncología (Guayaquil) ; 28(2): 112-127, Ago. 30, 2018.
Artigo em Espanhol | LILACS | ID: biblio-1000134

RESUMO

Introducción: Los sarcomas de partes blandas son tumores poco comunes, se presentan en mayor prevalencia en extremidades y su base de tratamiento es la resección quirúrgica acompañada de tratamiento radio y quimioterápico. El objetivo del presente estudio es describir las características clínicas y la supervivencia de un grupo de pacientes con sarcomas de partes blandas presentados en un centro único oncológico en la ciudad de Cuenca-Ecuador. Métodos: En el servicio de Clínica del Instituto de Cáncer de Solca-Cuenca, durante el período Enero del 2002 a Diciembre 2012 se realizó un estudio descriptivo, retrospectivo. Se analizaron todos los casos de pacientes derivados del área con diagnóstico de Sarcoma de partes blandas. Se excluyeron pacientes con neoplasias de origen secundario, con historias clínicas incompletas que imposibilitaron el análisis y menores de edad. Se estudiaron las variables sexo, edad, localización del tumor, diagnostico histopatológico y supervivencia. El análisis estadístico realizado fue descriptivo. Resultados: Se analizaron 71 casos, 37 mujeres (52.1 %). Las lesiones estuvieron localizados en el miembro inferior en 38 casos (53.5%) y en el miembro superior 10 casos (14.1 %.). La edad más frecuente en los 68-77 años 16 casos (22.5%). El tipo histológico más prevalente fue el Liposarcoma en 34 casos (47.9 %) y leimiosarcoma en 15 casos (21.1 %). En los casos analizados el grado de diferenciación que con más frecuencia se presentó fue el grado III 30 casos (42.3%). El estadío clínico II fue el más prevalente con 27 casos (38 %). El tratamiento quirúrgico de resección se aplicó en 59 casos (83.1 %). En 20 casos (28.2 %) se trataron con Radioterapia Adyuvante, y en 24 casos (33.8 %) se trataron con Quimioterapia Adyuvante. La supervivencia global del grupo fue 36.5 meses, la supervivencia media libre de progresión del grupo estudiado fue de 22.7 meses. Conclusión: En este reporte el sexo, la ubicación el tipo histológico y la supervivencia son variables que coinciden con los reportados con la comunidad científica. El manejo quirúrgico se realizó en la mayoría de casos con manejo Radio y Quimio ­terápicos Adyuvantes


Introduction: Soft tissue sarcomas are uncommon tumors, they present a higher prevalence in extremities and their treatment base is surgical resection accompanied by radio and chemotherapy treatment. The aim of the present study is to describe the clinical characteristics and survival of a group of patients with soft tissue sarcomas presented in a single oncological center in the city of Cuenca-Ecuador. Methods: In the Clinical Service of the Cancer Institute of Solca-Cuenca, a descriptive, retrospective study was carried out during the period from January 2002 to December 2012. We analyzed all cases of patients derived from the area with a diagnosis of soft tissue sarcoma. We excluded patients with neoplasms of secondary origin, with incomplete medical records that made analysis impossible and underage. The variables sex, age, tumor location, histopathological diagnosis and survival were studied. The statistical analysis performed was descriptive. Results: We analyzed 71 cases, 37 women (52.1%). The lesions were located in the lower limb in 38 cases (53.5%) and in the upper limb 10 cases (14.1%.). The most frequent age in 68-77 years 16 cases (22.5%). The most prevalent histological type was Liposarcoma in 34 cases (47.9%) and leimiosarcoma in 15 cases (21.1%). In the cases analyzed, the degree of differentiation that was most frequently presented was grade III, 30 cases (42.3%). Clinical stage II was the most prevalent with 27 cases (38%). The surgical treatment of resection was applied in 59 cases (83.1%). In 20 cases (28.2%) they were treated with adjuvant radiotherapy, and in 24 cases (33.8%) they were treated with adjuvant chemotherapy. The overall survival of the group was 36.5 months, the median progression-free survival of the group studied was 22.7 months. Conclusion: In this report, sex, location, histological type and survival are variables that coincide with those reported with the scientific community. Surgical management was performed in the majority of cases with Radio and Chemo treatment -Adjuvant therapies.


Assuntos
Humanos , Masculino , Feminino , Idoso , Sarcoma , Sobrevivência , Lipossarcoma , Radioterapia , Cirurgia Geral , Neoplasias
15.
Int. braz. j. urol ; 44(3): 642-644, May-June 2018. graf
Artigo em Inglês | LILACS | ID: biblio-954048

RESUMO

ABSTRACT Renal replacement lipomatosis is a condition characterized by varying degrees of renal parenchymal atrophy and perirenal fibrofatty proliferation secondary to chronic inflammation such as xanthogranulomatous pyelonephritis. In severe cases, imaging findings can be misdiagnosed as retroperitoneal liposarcoma.


Assuntos
Humanos , Masculino , Neoplasias Retroperitoneais/diagnóstico por imagem , Pielonefrite Xantogranulomatosa/diagnóstico , Nefropatias/diagnóstico por imagem , Lipomatose/diagnóstico por imagem , Lipossarcoma/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Pielonefrite Xantogranulomatosa/patologia , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Nefropatias/patologia , Lipomatose/patologia , Lipossarcoma/patologia , Pessoa de Meia-Idade
17.
Rev. Asoc. Méd. Argent ; 131(1): 10-13, mar. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-973093

RESUMO

Paciente masculino de 48 años con antecedente de hipertensión, que consulta por dolor abdominal difuso continuo, anorexia y aumento progresivo del perímetro abdominal. Al examen por TC se observa importante formación sólida heterogénea de densidad predominantemente grasa, que ocupa la casi totalidad del abdomen con desplazamiento de estructuras del abdomen superior; luego de la administración de medio de contraste formación presenta además componente de densidad de partes blandas de aspecto vegetante con realce heterogéneo que infiltra el retroperitoneo. Luego de su recesión completa, se concluye con el diagnostico de liposarcoma.


48 years old male patient with a history of hypertension, that consultation by diffuse abdominal pain continued, anorexia and progressive increase in the abdominal circumference. To review by TC is important training solid heterogeneous density predominantly fat that occupies almost the whole of the abdomen with displacement of structures in the upper abdomen, after the administration of contrast medium training is also a component of soft tissue density of vegetative aspect with heterogeneous enhancement that infiltrates the retroperitoneum, after his complete recession, it is concluded with the diagnosis of liposarcoma.


Assuntos
Masculino , Humanos , Pessoa de Meia-Idade , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Tomografia Computadorizada Multidetectores , Lipossarcoma/patologia , Neoplasias Retroperitoneais/patologia , Procedimentos Cirúrgicos do Sistema Digestório
18.
Rev. chil. cir ; 69(6): 498-501, dic. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-899644

RESUMO

Resumen Las neoplasias retroperitoneales suponen un reto para el profesional sanitario, tanto en el diagnóstico como en el tratamiento. Caso clínico: Varón de 56 años diabético tipo 2. Acude por edema en extremidad inferior derecha y parestesias. Se realiza ecografía doppler con resultados de trombosis venosa profunda y conglomerado adenopático. En TAC abdominal se observa gran masa retroperitoneal que engloba paquete vasculonervioso iliaco derecho. Se realiza vaciamiento ganglionar con resultado inicial de hamartoma. Se practica cirugía de resección de la masa y ligadura de la vena iliaca externa trombosada preservando la arteria iliaca. Anatomía patológica intraoperatoria sugestiva de sarcoma y definitiva de liposarcoma. Reingresa por shock hipovolémico y rotura de la arteria iliaca derecha. Se realiza ligadura y bypass femoro-femoral izquierdo-derecho. Al alta es derivado a oncología, falleciendo a los 6 meses. Discusión: El sarcoma es el tumor primario más frecuente a nivel retroperitoneal (15%). De difícil diagnóstico y tardío tratamiento, suelen ser asintomáticos hasta que debutan como una masa y clínica de compresión local o afectación de estructuras vasculonerviosas. El TAC es la prueba diagnóstica de elección. El tratamiento del tumor localizado es la cirugía; la radioterapia y quimioterapia se reservan para tumores irresecables o de alto grado.


Abstract Retroperitoneal neoplasias may be a diagnostic and therapeutic challenge for the clinician. Case report: A 56 year old male with prior history of type 2 diabetes consults with right inferior limb edema and paresthesias. He was diagnosed of deep vein thrombosis and lymph node conglomerate by ultrasound. A CT scan was performed, observing great retro peritoneal mass enclosing vascular and nervous structures. An initial histological diagnosis of hamartoma was made. Surgery was scheduled to remove the tumour, ligation of thrombosed external iliac vein and the external iliac artery was preserved. Intraoperative histological findings suggested sarcoma, definite studies showed presence of high grade liposarcoma. Two weeks after the intervention, the patient presents in hypovolemic shock due to rupture of the right external iliac artery. Emergent ligation of the artery and femorofemoral bypass was performed, with adequate postoperatory recovery. The patient was discharged and continued adjuvant oncology treatment and was exitus six months later. Discussion: Sarcomas are the most frequent primary retroperitoneal tumours. They are difficult to diagnose and often have untimely treatment. Sarcomas tend to be asymptomatic, or present with local compression symptoms, affecting vascular and nervous structures. CT scan is the gold standard for diagnostic imaging. Treatment requires a multidisciplinary approach, surgical resection as the main therapy; radio and chemotherapy represents a solution for irresectable or high grade malignancies.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retroperitoneais/cirurgia , Neoplasias Retroperitoneais/complicações , Lipossarcoma/cirurgia , Lipossarcoma/complicações , Neoplasias Retroperitoneais/diagnóstico por imagem , Choque/etiologia , Trombose/etiologia , Tomografia Computadorizada por Raios X , Artéria Ilíaca , Lipossarcoma/diagnóstico por imagem
19.
Rev. guatemalteca cir ; 23(1): [71-75], ene-dic,2017. graf
Artigo em Espanhol | LILACS | ID: biblio-884891

RESUMO

Los liposarcomas son tumores poco frecuentes, de comportamiento clínico silencioso y evolución variable dependiendo del tipo histológico, la recurrencia local y las metástasis a distancia. El tratamiento de elección es la resección quirúrgica total del tumor. Se presenta el caso de paciente femenina de 57 años de edad que consultó por tumor retroperitoneal cuyo diagnóstico por patología fue de liposarcoma bien diferenciado. Se reseca la totalidad el tumor, preservando el riñón derecho. Conclusión. La cirugía en caso de liposarcoma retroperitoneal es el tratamiento de elección donde la radioterapia y la quimioterapia juegan un papel controversial.


Liposarcomas are rare tumours, of silent clinical behavior and variable evoluton depending on histological type, local recurrence and distant metastases. Treatment of choice is tumors' complete surgical resecton. We hereby report the case of a 57-year-old female patent with a retroperitoneal tumor, whose fnal diagnosis was well-diferentated liposarcoma. The entre tumor was resected, preserving the right kidney. Conclusion. For Retroperitoneal Liposarcoma, surgery is the treatment of choice


Assuntos
Humanos , Feminino , Lipossarcoma/diagnóstico , Complicações do Diabetes/diagnóstico , Tomografia Computadorizada por Raios X/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...