Orbital Liposarcoma-A Case Report

眼窩脂肪肉瘤－病例報告

施智偉(Chih-Wei Shih) ； 吳振都(Chen-Tu Wu) ； 曾漢民(Han-Min Tseng) ； 廖述朗(Shu-Lang Liao)

《中華民國眼科醫學會雜誌》 48卷2期 (2009/06) Pp. 177-182

https://doi.org/10.30048/ACTASOS.200906.0009

摘要

目的：報告一個眼窩脂肪肉瘤，接受腫瘤手術切除和輔助性放射線治療的病例。
方法：病例報告。
結果：一名二十一歲男性主訴右眼有無痛的眼球突出兩個月。電腦斷層掃描發現位於右眼窩內側的眼球後腫瘤。病患接受腫瘤切除手術，最初的組織病理學診斷是纖維脂肪瘤。術後追蹤發現一復發性腫瘤，於是病患再次接受腫瘤切除手術。比對這兩次的切片，最終的病理組織學診斷為分化下全之脂肪肉瘤(dediffrentiated liposarcoma)。由於腫瘤於第二次術後再次復發，病患接受了右眼窩剜除術(exenteration)以達到腫瘤的完全切除。手術後病患並接受輔助性的放射線療法以降低腫瘤擴散的機率。在右眼窩剜除術三十八月後，並沒有腫瘤復發或轉移的現象發生。
結論：雖然眼窩脂肪肉瘤很罕見，仍需列入眼窩腫瘤的鑑別診斷之一大範圍的切除是最佳的治療方法。腫瘤切除後的放射線療法可以用來消除殘存或附庸的病灶。

並列摘要

Purpose: To report a case of orbital liposarcoma treated with tumor excision and complementary radiotherapy.
Method: A case report.
Result: A 21 year-old male presented with painless proptosis of the right eye for two months. The computed tomography scan showed a retrobulbar mass in the medial orbit. Tumor excision was done and the initial histopathologic diagnosis was fibrolipoma. A recurrent mass was noted later and tumor excision was performed again. Reviewing the serial histopathologic slides led to the diagnosis of dedifferentiated liposarcoma with areas of chondrosarcoma differentiation. Due to tumor recurrence after the second operation, exenteration of the right orbit was done to achieve total tumor removal. Complementary radiotherapy was delivered to reduce the chance of micrometastasis. There was no evidence of local recurrence or distant metastasis 38 months after exenteration.
Conclusion: Although rare, orbital liposarcoma should be included in the differential diagnosis of orbital tumors. Wide excision is the treatment of choice. Postoperative radiotherapy could be beneficial for possible residual or satellite lesion.

並列關鍵字

liposarcoma ； orbit