背景:脂肪瘤是一种常见的脂肪组织良性肿瘤,发病率接近10%。它是全身最常见的间充质肿瘤。然而,脂肪瘤的发病机制尚不清楚,发病率的增加归因于肥胖,血清胆固醇升高,糖尿病,创伤,辐射,家族性倾向,和染色体。原发性网膜肿瘤是一种发生在大网膜的罕见脂肪瘤,其中大多数以临床病例报告的形式报告。然而,原发性网膜肿瘤在儿童中更为罕见。迄今为止,很少有临床病例的报道。
方法:我们报告一例6岁男孩的原发性网膜脂肪瘤的罕见病例。意外摔倒后,CT扫描发现他的左上腹部有一个肿瘤。他没有腹痛史,腹部肿块,呕吐,等。这名男孩在三天内被送进医院,被诊断为腹内肿瘤.入院后,腹部超声和增强CT显示左侧中腹部71×40×60mm肿块,被认为是脂肪瘤.肿瘤标志物无异常。通过腹腔镜手术,术中探查显示肿瘤位于左中上腹部,是黄色的,固体,软,和孤立。术中诊断为网膜脂肪瘤。我们使用超声刀切除了靠近肿瘤底部的网膜。肿瘤完全切除,放入检索袋中并密封。最后,将脐带切口的左右两侧延长以取出肿瘤组织。手术后6小时,孩子接受了液体食物,3天后出院。术后病理诊断为网膜脂肪瘤。他在出院后3个月的随访中被发现,没有任何投诉,超声检查显示无肿瘤复发.
结论:儿童原发性网膜脂肪瘤是一种罕见的网膜良性肿瘤。其病因和病理尚不清晰。US,CT,MRI可以促进临床诊断和术前评估。腹腔镜手术是一种有效的治疗方法,儿童预后良好。该病例有利于提高儿科外科医生对这种罕见疾病的临床认识。
BACKGROUND: Lipoma is a common benign tumor derived from adipose tissue, with an incidence of nearly 10%. It is the most common mesenchymal tumor throughout the body. However, the pathogenesis of lipoma is not clear yet, and the increased incidence is attributable to obesity, elevated serum cholesterol, diabetes, trauma, radiation, familial predisposition, and chromosome. Primary omental tumor is a rare lipoma occurring in the greater omentum, most of which is reported in the form of clinical
case reports. Nevertheless, primary omental tumor is even rarer in children. To date, there have been few
reports of clinical cases.
METHODS: We report a rare
case of primary omental lipoma in a 6-year-old boy. After an accidental fall, a CT scan found that he had a tumor in the left upper abdomen. He had no history of abdominal pain, abdominal mass, vomiting, etc. The boy was admitted to the hospital within 3 days, and was diagnosed with an intra-abdominal tumor. After admission, abdominal ultrasound and enhanced CT showed a 71 ×40 ×60 mm mass in the left middle abdomen, which was considered a lipoma. There was no abnormality in tumor markers. Through laparoscopic surgery, intraoperative exploration revealed that the tumor was located in the left mid-upper abdomen, and was yellow, solid, soft, and isolated. The intraoperative diagnosis was an omental lipoma. We used an ultrasonic knife to resect the omentum close to the base of the tumor. The tumor was completely resected, put in a retrieval bag and sealed. Finally, the left and right sides of the umbilical incision were extended to take out the tumor tissue. The child received liquid food 6 h after the operation and was discharged 3 days later. The postoperative pathological diagnosis was an omental lipoma. He was seen at follow-up 3 months after discharge and had no complaints, an abnominal ultrasound showed no tumor recurrence.
CONCLUSIONS: Primary omental lipoma in children is a rare benign tumor of the omentum. Its etiology and pathology are not clear.
US, CT, and MRI can facilitate clinical diagnosis and preoperative evaluation. Laparoscopic surgery is an effective treatment, and the prognosis of children is favorable. This case is beneficial to improve the clinical knowledge of pediatric surgeons about this rare disease.