摘要
脂肪肉瘤(liposarcoma)爲成人常見肉瘤，好發於四肢和後腹腔，原發於頭頸部者甚少。喉部及下咽部脂肪肉瘤成長緩慢，初期無明顯症狀，在病理分類上大多爲分化良好型或類黏液型，兩者皆爲低惡性度，少有頸部淋巴或遠端轉移。治療以手術廣泛切除爲優先選擇，並輔以術後放射治療，其局部復發率甚高，宜長期追蹤。本部於2006年4月切除一病患下咽部復發腫瘤，診斷爲脂肪肉瘤，檢視2002年切除腫瘤之切片，發現其中已含有極少數的惡性細胞。此病患在術後一個月回門診追蹤時發現仍有殘存腫瘤，因病人拒絕手術處理，安排接受放射治療後腫瘤明顯縮小，目前於放射腫瘤科門診追蹤。分化良好的脂肪肉瘤容易被誤診爲脂肪瘤，脂肪瘤的復發率明顯較脂肪肉瘤爲低，臨床上若發現有復發脂肪瘤，應審慎檢視病理切片避免誤診。
並列摘要
Liposarcoma is one of the most common soft tissue sarcomas occurring in adults. The two major sites are the extremities and the retroperitoneum. On rare occasions, these tumors arise in the head and neck region. Primary liposarcomas of the larynx and pharynx grow slowly and rarely affect the neck lymph nodes or give rise distant metastases. The most common histological types are the well-differentiated and myxoid types. Both of these types show a low grade of malignancy. Wide excision is the treatment of choice and post-operative radiotherapy may be an adjunct approach. The local recurrence rate is high and long term follow-up is needed. We encountered a case of recurrent hypopharyngeal liposarcoma tumor in April 2006. The pathology results for the excised recurrent tumor were liposarcoma. We reviewed the histological specimens of the previous tumor, which had been excised in 2002 and had been diagnosed as lipoma. It was possible with hindsight to identify a few malignant cells in the previous biopsy. Radiotherapy was indicated because the patient refused further surgical excision. The tumor regressed obviously after the treatment course and the patient has had follow-up at the Department of Radiotherapy since the treatment finished. Welldifferentiated liposarcoma is commonly misdiagnosed as lipoma. The recurrence rate of lipoma is much lower than that of liposarcoma. Based on this, with a recurrent lipoma, the pathological information should be reviewed cautiously.
延伸閱讀
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