孤立性腹膜転移を契機に発見された後腹膜脂肪肉腫の１例

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  • A Case of Retroperitoneal Liposarcoma Presented with Solitary Peritoneal Metastasis to the Cecum.

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A 70-year-old man was admitted to the hospital because of a mass in the right lower quadrant of abdomen. Abdominal CT scan visualized an irregular shaped, homogeneous-appearance mass in the lateral side of the cecum and two heterogenous mass lesions in the upper and medial side of the iliopsoas muscle. Barium enema revealed a hypotention of the cecum wall. From the above findings, he was diagnosed as having sarcoma of the cecum with lymph node metastasis or other retroperitoneal tumor. At operation, a fist sized tumor strongly fixed to the wall of the cecum and two pigeon egg sized tumors were located surrounding by the right common iliac artery. Ileocecal resection, a lymphadenectomy and a tumorectomy were performed. Histological examination of the tumors on the iliopsoas muscle showed well differentiated liposarcoma. The tumor clinically diagnosed as cecal sarcoma before operation was pleomorphic liposarcoma, which invaded the cecum extraluminally. Definite diagnosis was solitary peritoneal metastasis from well differentiated liposarcoma. Retroperitoneal liposarcoma which lacks clinical manifestations is often found after it has formed a giant mass. We report this case because of its unusual pattern of tumor extension.

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