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Dedifferentiated liposarcoma and abdominal skin flap reconstruction: the importance of the Cancer Center
Apresentação do caso
The case reported is an 86-year-old male patient that presented a mass of 6,0 x 4,0 cm in the inguinal region with slow and progressive growth for 2 years. The main diagnosis suspected was lipoma. The patient underwent a local resection with an incidental diagnosis of dedifferentiated liposarcoma in the inguinal region in 2015, with regular oncological follow-up since then. He presented local recurrence in August 2017 and was submitted to successful oncological resection. In 2021, there was a new recurrence in the same topography, with fast and progressive growth in the right inguinal-perineal region. The patient underwent extensive resection of the lesion in the lower abdominal wall with right inguinal lymphadenectomy associated with orchiectomy. Surgical specimens submitted to histopathological study indicated the diagnosis of undifferentiated pleomorphic sarcoma with spermatic cord involvement and without angiovascular invasion. We opted for reconstruction of the abdominal wall with a Proceed mesh and reconstruction with an abdominal and myocutaneous skin flap of the tensor fascia lata muscle on the right.
It is known that soft tissue sarcomas are rare tumors, among them liposarcoma is the most common malignant histological type and its diagnosis is easily confused with lipoma. Myxoid liposarcoma is the most common among all types of liposarcomas, with an incidence predominantly around the 5th decade of life, mainly affecting the lower limbs and rarely the mediastinum. The prognosis of patients is directly related to the grade of tumor differentiation, with a favorable prognosis for well-differentiated and myxoid liposarcomas. High-grade, pleomorphic and dedifferentiated tumors, on the other hand, have a worse prognosis.
Soft tissue sarcomas are rare and liposarcoma is the most common among them with frequent underdiagnosis of lipoma. The aforementioned patient had his diagnosis made incidentally showing the importance of the cancer centre on the treatment of rare diseases, enabling him to receive adequate treatment and follow-up. Last resection was performed in the lower abdominal wall with right inguinal lymphadenectomy associated with orchiectomy. Reconstruction of the abdominal wall with a Proceed mesh and reconstruction with an abdominal and myocutaneous skin flap of the tensor fascia lata muscle on the right. The surgery had excellent oncological, functional and esthetic results.
Dedifferentiated liposarcoma; abdominal skin flap reconstruction; cancer center
Tumores De Partes Moles e Retroperitônio
PRISCILA FERREIRA SOTO, JADIVAN LEITE DE OLIVEIRA, LUIZ FERNANDO NUNES, NELSON JOSÉ JABOUR FIOD, KAIQUE TORRES FERNANDES, JULIANA VETORAZO ALVARENGA, SARAH HULLIANE FREITAS PINHEIRO DE PAIVA, LÁLYA CRISTINA SARMENTO-FREITAS, ROBERTO ANDRÉ TORRES VASCONCELOS, MAURISTON RENAN MARTINS SILVA, DOUGLAS BARRADA RIBEIRO