■粘液样脂肪肉瘤(MLS)是一种罕见的恶性软组织肉瘤,主要表现在四肢的深层软组织,特别是在大腿的肌肉组织内。不像其他类型的脂肪肉瘤,MLS表现出转移到非典型部位的倾向,包括肺实质,软组织,腹膜后,纵隔,乳房,肝脏,胸腺,淋巴结,和骨头。明确的诊断主要依赖于HE染色的组织学。成像模式,如超声,CT,MRI,和18F-FDGPET/CT扫描可作为肿瘤鉴定的有价值的工具。
■一名57岁男子1个月前出现腹胀和呕吐症状。对比增强CT显示左肾中上段有不均匀的低密度肿块,表现出不规则的形态和向肾脏外部突出,血液供应丰富,最大尺寸约为10.7cm×9.0cm。此外,胰腺体内发现了一个圆形的软组织密度.多平面重建显示胰腺病变与肾脏肿块之间存在联系。进行18F-FDGPET/CT分期,显示左肾中上部分的病变显著增长,延伸到肾脏并浸润胰体.病变表现出显著高的18F-FDG摄取(SUVmax=10.2,MTV=136.13cm3,TLG=484.62)。术后病理检查证实诊断为MLS。手术后第10天,患者出现肿瘤复发,并接受了另一次手术切除.不幸的是,手术期间,患者心脏骤停并死亡.
■侵入胰腺的肾脏MLS在临床实践中非常罕见。由于在这种特殊情况下对18F-FDGPET/CT的利用研究有限,鉴于MLS的罕见性和低发病率,它的作用在很大程度上仍未被探索。随着PET/CT成像的日益普及,疾病部位的全面成像对于治疗方案的制定和治疗反应的监测是必不可少的。
UNASSIGNED: Myxoid liposarcoma (MLS) is a rare malignant soft tissue sarcoma that predominantly manifests in the deep soft tissues of the extremities, particularly within the musculature of the thigh. Unlike other types of liposarcoma, MLS demonstrates a propensity for metastasis to atypical sites, including the lung parenchyma, soft tissues, retroperitoneum, mediastinum, breast, liver, thymus, lymph nodes, and bones. The definitive diagnosis primarily relies on histology with HE staining. Imaging modalities such as ultrasound, CT, MRI, and 18F-FDG PET/CT scans serve as valuable tools for tumor identification.
UNASSIGNED: A 57-year-old man presented with symptoms of abdominal distention and vomiting 1 month ago. Contrast-enhancement CT revealed a heterogeneous hypodense mass in the upper-middle part of the left kidney, displaying irregular morphology and protrusion towards the exterior of the kidney, with abundant blood supply and had a maximum dimension of approximately 10.7 cm × 9.0 cm. Additionally, a rounded soft tissue density was identified in the pancreatic body. Multiplanar reconstruction demonstrated a connection between the pancreatic lesion and the kidney mass. 18F-FDG PET/CT was conducted for staging, revealing significant growth of the lesion in the upper-middle part of the left kidney, extending beyond the kidney and infiltrating the pancreatic body. The lesion demonstrated remarkably high 18F-FDG uptake (SUVmax = 10.2, MTV = 136.13 cm3, TLG = 484.62). The postoperative pathological examination confirmed the diagnosis of MLS. On the 10th day post-surgery, the patient presented with tumor recurrence and underwent another surgical resection. Unfortunately, during the operation, the patient experienced a sudden cardiac arrest and died.
UNASSIGNED: Renal MLS with invasion into the pancreas is very rare in clinical practice. Due to the limited research on the utilization of 18F-FDG PET/CT in this particular context, given the rarity and low incidence of MLS, its role remains largely unexplored. As PET/CT imaging becomes increasingly prevalent, thorough imaging of disease sites becomes indispensable for the development of treatment protocols and the monitoring of treatment response.