Myxoid Liposarcoma: A Soft-Tissue Sarcoma Mimicking Hematoma in A Baseball Player

黏液型脂肪肉瘤：於棒球員發現類似血腫之軟組織肉瘤

李珈樺(Chia-Hua Lee) ； 蔡鎬鴻(Hao-Hung Tsai) ； 羅逸然(Yat-Yin Law) ； 林傳朝(Chuan-Chao Lin)

《台灣復健醫學雜誌》 49卷2期 (2021/12) Pp. 205-211

https://doi.org/10.6315/TJPMR.202112_49(2).0007

摘要

There are multiple histological types of soft-tissue sarcomas (STS) that are associated with different prognoses. Liposarcoma (LPS) is the most frequent subtype of STS in extremities and trunk wall in Taiwan.The myxoid liposarcoma is the second most common subtype of LPS and is associated with an intermediate-grade malignancy. STS and hematoma may be difficult to differentiate clinically. We report a case of a 35-year-old male presented with a mass lesion over the left thigh, which was initially misinterpreted as a hematoma on ultrasound. We also conducted a magnetic resonance imaging (MRI) study, which revealed the possible diagnosis of STS. After operation and histopathological examination, the diagnosis of myxoid liposarcoma was confirmed. We conducted a literature review of the clinical presentation, ultrasonic, and MRI findings to assess characteristics that will help the physician differentiate between hematomas and STS.

關鍵字

soft tissue sarcoma ； liposarcoma ； myxoid liposarcoma ； hematoma ； ultrasound

並列摘要

軟組織肉瘤有多種型態之組織病理亞型及分型，各亞型有各種不同的預後。一篇以台灣人口作為研究之報告顯示位於四肢及軀幹的軟組織肉瘤中，脂肪肉瘤是最常見的亞型，而脂肪肉瘤中第二常見的亞型為中度惡性的黏液型脂肪肉瘤。臨床上，軟組織肉瘤及血腫可能很難作鑑別診斷。本文中，我們報導了一位35歲男性，因為左側大腿疼痛而求診，理學檢查發現一顆位於左側大腿腫塊，經骨骼肌肉超音波檢查後一開始認為是血腫，安排核磁共振影像顯示左側大腿腫塊懷疑為軟組織肉瘤，經手術切除後，病理組織學檢查報告確診為黏液型脂肪肉瘤。本文將討論軟組織肉瘤相關臨床徵象、骨骼肌肉超音波及核磁共振影像，根據評估疾病的特徵，期望能幫助醫師於臨床上鑑別血腫及軟組織肉瘤。

並列關鍵字

軟組織肉瘤（soft tissue sarcoma） ； 脂肪肉瘤（liposarcoma） ； 黏液型脂肪肉瘤（myxoid liposarcoma） ； 血腫（hematoma） ； 超音波（ultrasound）

參考文獻

Hung GY, Yen CC, Horng JL, et al. Incidences of primary soft tissue sarcoma diagnosed on extremities and trunk wall: A population-based study in Taiwan. Medicine (Baltimore) 2015;94:e1696.

Loubignac F, Bourtoul C, Chapel F. Myxoid liposarcoma: a rare soft-tissue tumor with a misleading benign appearance. World J Surg Oncol 2009;7:42.

Shimamori N, Kishino T, Morii T, et al. Sonographic appearancesof liposarcoma: correlations with pathologic subtypes. Ultrasound Med Biol 2019;45:2568-74.

El Ouni F, Jemni H, Trabelsi A, et al. Liposarcoma of the extremities: MR imaging features and their correlation with pathologic data. Orthop Traumatol Surg Res 2010;96:876-83.

Hoshi M, Oebisu N, Ieguchi M, et al. Clinical features of soft tissue sarcoma presenting intra-tumour haematoma: case series and review of the literature. Int Orthop 2017;41:203-9.