足部脂肪肉瘤併發頸椎轉移

黏液型脂肉瘤(myxoid liposarcoma)，是脂肪肉瘤(liposarcoma)的亞型，其脂肪含量很少。脂肪肉瘤是成人第二常見的軟組織肉瘤；黏液型脂肉瘤是第二常見的脂肪肉瘤。腫瘤經診斷並手術切除後，需配合化學治療及放射線治療，減少局部復發及轉移的可能性。須定期安排胸腔及腹腔的影像追蹤，病患出現神經症狀時，必須考慮脊椎骨的侵犯，並進一部安排適當的檢查，以便早期評估腫瘤轉移壓迫的可能性。我們報告一位五十歲女性，以右側足部侵犯為開始，病理切片顯示黏液型脂肉瘤，手術進行右膝下截肢手術，同時發現肝臟及肺臟轉移，使用臏骨承重(patellar tendon bearing)義肢，經復健後功能上可行走及自理。五個月後，頸部疼痛及四肢麻痛無力及尿滯留，證實為黏液型脂肉瘤轉移至第三第四頸椎骨合併脊髓壓迫，進行椎板切除術(laminectomy)，原本患者臥床需人餵食，經復健治療，可維持坐姿穩定並自行進食。診斷11個月後，患者肝臟衰竭死亡。

關鍵字

脂肪肉瘤；膝下截肢；轉移

並列摘要

Myxoid liposarcoma is a subtype of liposarcoma that has little fat. In adults, liposarcoma is the second most common type of soft tissue sarcoma. Myxoid liposarcoma is the second most type of liposarcoma. The surgical intervention for this disease is removal of the tumor. After surgery, a combination of chemotherapy and radiotherapy is able to reduce recurrent and metastasis. Periodic surveys of the chest and abdomen are necessary. If there is a neurological deficit, then the focus needs to be the spinal area. Further surveys are necessary to evaluate whether there is metastasis. We present here the case of a 50-year-old woman who had complained of a right foot mass for 3 years. The pathology report indicated myxoid lipoarcoma. Tanstibial amputation was performed. Imaging studies showed liver and lung metastasis. She was able to ambulate independentlyusing a patellar tendon bearing prosthesis after rehabilitation training. Five months later, she complained of neck pain, urinary retention, numbness in four limbs and weakness. The diagnosis was myxoid liposarcoma with 3rd and 4th cervical metastasis and spinal cord compression. She received mass removal and laminectomy. After rehabilitation, her ADL functioning and balance improved. She expired due to liver failure 11 months later.

並列關鍵字

liposarcoma ； ranstibial amputation ； metastasis

國際替代計量

足部脂肪肉瘤併發頸椎轉移

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