Ung thư mỡ sau phúc mạc tái phát – nhân 4 trường hợp=Recurrence of retroperitoneal liposarcoma

Ung thư mỡ sau phúc mạc tái phát – nhân 4 trường hợp=Recurrence of retroperitoneal liposarcoma – 4 case study

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Tác giả: Thanh Tùng Hồ, Văn Lượng Lê, Văn Đạt Lưu, Sỹ Thanh Nam Ngô, Dương Hùng Nguyễn, Hữu Hùng Nguyễn, Văn Chiến Nguyễn, Đức Hùng Trần, Thái Sơn Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.216-224

Bộ sưu tập: Metadata

ID: 243870

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Liposarcoma is a tumor of lipoblasts, which is a rare mesenchymal tumor involving the deep soft tissues. Soft tissue sarcomas account for less than 1% of all malignant tumors in adults. Lipomas are the most common variant and account for approximately 15% of soft tissue tumors in adults. On the occasion of 4 cases of multiple recurrences of RT-LPS operated at the Department of Surgery at Tam Anh General Hospital, we write this article to review the diagnosis, classification and treatment for RT-LPS. LPS includes 5 types: atypical lipomatous tumors/well-differentiated liposarcoma, dedifferentiated liposarcoma, myxoid liposarcoma, pleomorphic liposarcoma and myxoid pleomorphic liposarcoma. Symptoms of RT-LPS depend on the location of the tumor, often caused by compression: pain, edema, loss of organ function, bloating, vomiting, constipation - defecation, etc. CT/MRI helps detect the location and nature of the tumor. R0 surgery is the main treatment method, radiotherapy ± adjuvant chemotherapy may be necessary for well differentiated cancers, with Myxoid liposarcoma and pleomorphic liposarcoma being sensitive to chemotherapy, however they has a low average survival rate.Ung thư mỡ là một khối u của nguyên bào mỡ, là một khối u trung mô hiếm gặp liên quan đến các mô mềm sâu. Sarcoma mô mềm chiếm chưa đến 1% trong tổng số các khối u ác tính ở người lớn. U mỡ là biến thể phổ biến nhất và chiếm khoảng 15% các khối u mô mềm ở người lớn. Nhân 4 trường hợp RT-LPS tái phát nhiều lần được phẫu thuật tại khoa Ngoại Bệnh viện Đa khoa Tâm Anh, chúng tôi viết bài này nhằm điểm lại chẩn đoán, phân loại và lựa chọn điều trị đối với RT-LPS. LPS gồm 5 loại: u mỡ không điển hình/sarcoma mỡ biệt hóa tốt, sarcoma mỡ không biệt hóa, sarcoma mỡ dạng niêm dịch, sarcoma mỡ đa hình thái và sarcoma mỡ đa hình dạng niêm dịch. RT-LPS thường không có triệu chứng dẫn đến phát hiện muộn, các triệu chứng phụ thuộc vị trí khối u, thường do sự chèn ép gây ra: đau, phù nề, mất chức năng cơ quan, đầy chướng bụng, nôn, bí trung – đại tiện,… CT/MRI giúp phát hiện vị trí, tính chất khối u. Về điều trị, phẫu thuật R0 là nguyên tắc cơ bản, xạ trị ± hóa trị bổ trợ, điều trị đích hiện vẫn còn đang nghiên cứu và cho thấy ít có hiệu quả, có thể chỉ định với các ung thư biệt hóa cao, với ung thư mỡ dạng Myxoid và ung thư mỡ đa hình thì nhạy cảm với hóa trị, tuy nhiên chúng có tỷ lệ sống sót trung bình thấp.

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