Bacakta sekonder deri tutulumlu rekürren miksoid liposarkom: Olgu sunumu

Amaç: Liposarkomlar yağ hücrelerinden köken alan malign tümörlerdir. Liposarkomlar çeşitli kategorilere ayrılırlar: iyi diferansiye, miksoid/yuvarlak hücreli, pleomorfik ve dediferansiye tip. Bu olgu sunumunda sekonder deri tutulumu olan bir miksoid liposarkom olgusunun cerrahi tedavisi ve bu vesile ile bu konuda genel bilgiler verilmesi amaçlanmıştır. Olgu sunumu: 31 yaşında erkek hasta sol bacak posteriorunda multipl tümöral kitle ile kendini gösteren rekürren miksoid liposarkom tedavisi için başvurdu. Tümöral nodüllerin geniş en blok eksizyonu yapılarak oluşan defekt deri grefti ile kapatıldı. Sonuç: Hastanın postoperatif izleminde herhangi bir sorun olmadı. Cerrahi materyalin incelemesi sonucunda miksoid liposarkom tanısına ulaşıldı. Miksoid liposarkomlar zayıf bir şekilde çevrelenmiş lezyonlar olup, eğer geniş ve derin cerrahi eksizyon yapılmazsa lokal olarak tekrarlayabilirler. Ayrıca lokal rekürrensin önlenmesinde adjuvan radyoterapi de önemlidir.

Recurrent myxoid liposarcoma of the leg with secondary skin involvement: Case report

Objective: Liposarcomas are malignant tumors originating from fat cells. There are several categories of liposarcomas: well differentiated, myxoid/round cell, pleomorphic, and dedifferentiated. Here we present experience with the surgical treatment of a case of myxoid liposarcoma of the leg with secondary skin involvement and general information about this tumor. Case report: A 31-year-old male patient with recurrent myxoid liposarcoma presented with multiple tumoral masses on the posterior aspect of his left leg. Wide en bloc excision of the tumor nodules was performed and the resulting defect was covered with a skin graft. Conclusion: Postoperative course of the patient was uneventful. A diagnosis of myxoid liposarcoma was concluded after the histopathologic examination of the surgical specimen. Myxoid liposarcomas are poorly circumscribed lesions and may locally recur if wide and deep surgical resection of the lesion is not performed. Adjuvant radiotherapy is also important to decrease local recurrence.

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1. Fiore M, Grosso F, Vullo S, Pennacchi E, Stacchiot S, Ferrari A, et al. Myxoid/round cell and pleomorphic liposarcomas: Prognostic factors and survival in a series of patients treated at a single institution. Cancer 2007;109:2522-31.
2. Patel SR, Burgess MA, Plager C, Papadopoulos NE, Linke KA, Benjamin RS. Myxoid liposarcoma: Experience with chemotherapy. Cancer 1994;74:1265-9.
3. Orson GG, Sim FH, Reiman HM, Taylor WF. Liposarcoma of the musculoskeletal system. Cancer 1987;60:1362-70.
4. Smith TA, Easley KA, Goldblum JR: Myxoid/round cell liposarcoma of the extremities: A clinicopathologic study of 29 cases with particular attention to extent of round cell liposarcoma. Am J Surg Pathol 1996;20:171-80.
5. Jones RL, Fisher C, Al-Muderis O, Judson IR. Differential sensitivity of liposarcoma subtypes to chemotherapy. Eur J Cancer 2005;41:2853-60.
6. ten Heuvel SE, Hoekstra HJ, van Ginkel RJ, Bastiaannet E, Suurmeijer AJH. Clinicopathologic prognostic factors in myxoid liposarcoma: A retrospective study of 49 patients with long-term follow-up. Ann Surg Oncol 2007;14:222-9.
7. Anders KH: Neoplasms of the subcutaneous fat. İçinde: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editör. Fitzpatrick’s Dermatology in General Medicine. 6th ed ABD. McGraw-Hill Med. Pub; 2003 p.1067.
8. Takagi H, Kato K, Yamada E, Suchi T. Six recent liposarcomas including largest to date. J Surg Oncol 1984;26:260-7.
9. Watanabe H, Ohmori K, Kanamori M, Araki N, Yoshikawa H, Kimura T. A myxoid liposarcoma in the lower leg, with large intra-abdominal metastasis. J Orthop Sci 2001;6:95-7.
10. Weitz J, Antonescu CR, Brennan MF. Localized extremity soft tissue sarcoma: Improved knowledge with unchanged survival over time. J Clin Oncol 2003;21:2719-25.