临床外科杂志 ›› 2025, Vol. 33 ›› Issue (8): 895-896.doi: 10.3969/j.issn.1005-6483.20250163

• 临床病例报道 • 上一篇    

颈部脂肪瘤复发非典型脂肪瘤样肿瘤一例

  

  1. 350025 福建福州,福建中医药大学福总教学医院普通外科(第九〇〇医院)(高怡);福建医科大学福总临床医学院普通外科(刘婷婷、倪炜翔);中国人民解放军联勤保障部队第九〇〇医院普通外科(肖春红、房俊伟、洪伟煊、王烈)
  • 收稿日期:2025-02-24 修回日期:2025-02-24 出版日期:2025-08-20 发布日期:2025-08-20
  • 通讯作者: 肖春红,Email:xiao84chun@163.com

A case of recurrent atypical lipomatous tumor originating from cervical lipoma

  1. *Department of General Surgery,Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine(900th Hospital),Fuzhou 350025,China
  • Received:2025-02-24 Revised:2025-02-24 Online:2025-08-20 Published:2025-08-20

摘要: 脂肪源性肿瘤是最常见的软组织肿瘤,可分为脂肪瘤和脂肪肉瘤。研究发现,同一部位切除的良性脂肪瘤可转化为脂肪肉瘤,尤其是非典型脂肪瘤样肿瘤(atypical lipomatous tumor,ALT),暗示二者潜在生物学关联。本例病人2017年于我院行右颈部肿物切除,病理检查示纤维脂肪瘤。1年后原位复发未处理;至2023年肿物明显增大并向深部发展,MRI检查示病灶与周围脂肪分界不清,疑似脂肪肉瘤。穿刺及分子病理检查示MDM2基因扩增,诊断为ALT,手术完整切除后病理确诊。由此可见,脂肪源性肿瘤生物学行为差异较大,良性脂肪瘤可转化为脂肪肉瘤(尤其ALT)。临床需结合影像学、病理学及分子检测(如MDM2/CDK4)鉴别,以制定治疗方案。

关键词: 非典型脂肪瘤样肿瘤, 脂肪瘤, 脂肪肉瘤

Abstract: Adipocytic tumors are the most common type of soft tissue tumors, which can be divided into lipomas and liposarcomas. Studies have found that benign lipomas resected from the same site can transform into liposarcomas,especially atypical lipomatous tumors(ALT), suggesting an underlying biological association. In this case, the patient underwent resection of a right neck mass in our hospital in 2017, and the pathology showed fibrolipoma. One year later, the mass recurred at the original site but was not treated. By 2023, the mass had significantly enlarged and extended deeply. MRI showed that the lesion had an unclear boundary with the surrounding fat, suggesting liposarcoma. Puncture and molecular pathology showed MDM2 gene amplification, and the diagnosis of ALT was made, which was confirmed by pathology after complete surgical resection. It can be seen that adipocytic tumors have great differences in biological behavior, and benign lipomas can transform into liposarcomas (especially ALT). Clinically, it is necessary to combine imaging, pathology and molecular detection (such as MDM2/CDK4) for differentiation to formulate treatment plans.

Key words: atypical lipomatous tumor, lipoma, liposarcoma

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