학술논문
The Importance of Radiologic Signs for Giant Lipoma Differentiation From Low-grade Liposarcoma and Its Most Appropriate Surgical Treatment Protocol/Dev Lipomun Dusuk Dereceli Liposarkomdan Ayirt Edilmesinde Radyolojik Bulgularin Onemi ve En Uygun Cerrahi Tedavi Protokolu
Original Investigation / Orijinal Arastirma
Original Investigation / Orijinal Arastirma
Document Type
Report
Author
Source
Journal of Academic Research in Medicine. April 2022, Vol. 12 Issue 1, p15, 6 p.
Subject
Language
English
ISSN
2146-6505
Abstract
INTRODUCTION Lipoma is the most common soft tissue tumor (1). Giant lipomas usually present at a size exceeding 10 cm and a minimum weight of 1,000 g (2). Low-grade liposarcoma [...]
Objective: This study aimed to evaluate the importance of preoperative radiologic signs for giant lipoma differentiation from low-grade liposarcoma and reveal the appropriate surgical method. Methods: This study retrospectively evaluated 59 patients who underwent marginal and wide resection for giant lipomas (21 were females and 15 were males) and low-grade liposarcomas (14 were females and 9 were males). Pre-biopsy radiological signs were investigated using magnetic resonance images. The pre and postoperative functional results were evaluated using the Upper Extremity Functional Index (UEFI), Lower Extremity Functional Index (LEFS), and visual analogue scale (VAS). The functional results were evaluated according to the marginal and wide resection of these lesions. Results: The preoperative radiologic signs revealed no significant correlations between the thin septa with the giant lipoma or low-grade liposarcoma. However, a significant correlation was determined between the thick septa and globular area with low-grade liposarcoma and homogeneous mass with giant lipoma. Postoperative mid-term UEFI, LEFS, and VAS of the marginal and wide resection were significantly better than the preoperative functional results in both lesions. No differences were found between the preoperative and postoperative mid-term functional results in the marginal and wide resections of either lesion. Local recurrence was detected in four patients with low-grade liposarcoma who underwent marginal resection. Conclusion: Therefore, thick septa, confluent globular area, and nonadipose mass are distinctive for low-grade liposarcoma, and homogeneous mass is distinctive for giant lipoma. Moreover, it would be more appropriate to treat low-grade liposarcomas with wide surgical resection. Keywords: Giant lipoma, low-grade liposarcoma, surgical resection, local recurrence, functional results Amac: Bu calismada, dev lipom ve dusuk dereceli liposarkom ayriminda preoperatif radyolojik bulgularin oneminin degerlendirilmesi ve uygun cerrahi yontemin ortaya cikarilmasi amaclanmistir. Yontemler: Dev lipom (21 kadin,15 erkek) ve dusuk dereceli liposarkom (14 kadin, dokuz erkek) nedeniyle marjinal ve genis rezeksiyon yapilan 59 hasta retrospektif olarak degerlendirildi. Biyopsi oncesi radyolojik bulgular manyetik rezonans goruntuleri kullanilarak arastirildi. Ameliyat oncesi ve sonrasi fonksiyonel sonuclar Ust Ekstremite Fonksiyonel Indeksi (UEFI), Alt Ekstremite Fonksiyonel Indeksi (LEFS) ve gorsel analog skala (VAS) kullanilarak degerlendirildi. Bu lezyonlarin marjinal ve genis rezeksiyonuna gore fonksiyonel sonuclar degerlendirildi. Bulgular: Preoperatif radyolojik bulgulara gore ince septa ile dev lipom veya dusuk dereceli liposarkom arasinda anlamli bir iliski yoktu. Ancak dusuk dereceli liposarkomda kalin septa ve globuler alan gorulmesi ile dev lipomlu hastalarda homojen kitle gorulmesi arasinda anlamli bir iliski vardi. Postoperatif orta donem UEFI, LEFS ve VAS skorlari marjinal ve genis rezeksiyon icin preoperatif fonksiyonel sonuclardan anlamli derecede daha iyiydi. Her iki lezyonun da marjinal ve genis rezeksiyonlarinda preoperatif ve postoperatif orta donem fonksiyonel sonuclari arasinda fark yoktu. Marjinal rezeksiyon yapilan dort dusuk dereceli liposarkom hastasinda lokal nuks tespit edildi. Sonuc: Calismada dusuk dereceli liposarkom icin kalin septum, globuler alan ve nonadipoz kitlenin, dev lipom icin de homojen kitlenin ayirt edici oldugu sonucuna varildi. Bununla birlikte dusuk dereceli liposarkomlarin genis cerrahi rezeksiyon ile tedavi edilmesi daha uygun olacaktir. Anahtar kelimeler: Dev lipom, iyi diferansiye liposarkom, cerrahi rezeksiyon, lokal nuks, fonksiyonel sonuclar
Objective: This study aimed to evaluate the importance of preoperative radiologic signs for giant lipoma differentiation from low-grade liposarcoma and reveal the appropriate surgical method. Methods: This study retrospectively evaluated 59 patients who underwent marginal and wide resection for giant lipomas (21 were females and 15 were males) and low-grade liposarcomas (14 were females and 9 were males). Pre-biopsy radiological signs were investigated using magnetic resonance images. The pre and postoperative functional results were evaluated using the Upper Extremity Functional Index (UEFI), Lower Extremity Functional Index (LEFS), and visual analogue scale (VAS). The functional results were evaluated according to the marginal and wide resection of these lesions. Results: The preoperative radiologic signs revealed no significant correlations between the thin septa with the giant lipoma or low-grade liposarcoma. However, a significant correlation was determined between the thick septa and globular area with low-grade liposarcoma and homogeneous mass with giant lipoma. Postoperative mid-term UEFI, LEFS, and VAS of the marginal and wide resection were significantly better than the preoperative functional results in both lesions. No differences were found between the preoperative and postoperative mid-term functional results in the marginal and wide resections of either lesion. Local recurrence was detected in four patients with low-grade liposarcoma who underwent marginal resection. Conclusion: Therefore, thick septa, confluent globular area, and nonadipose mass are distinctive for low-grade liposarcoma, and homogeneous mass is distinctive for giant lipoma. Moreover, it would be more appropriate to treat low-grade liposarcomas with wide surgical resection. Keywords: Giant lipoma, low-grade liposarcoma, surgical resection, local recurrence, functional results Amac: Bu calismada, dev lipom ve dusuk dereceli liposarkom ayriminda preoperatif radyolojik bulgularin oneminin degerlendirilmesi ve uygun cerrahi yontemin ortaya cikarilmasi amaclanmistir. Yontemler: Dev lipom (21 kadin,15 erkek) ve dusuk dereceli liposarkom (14 kadin, dokuz erkek) nedeniyle marjinal ve genis rezeksiyon yapilan 59 hasta retrospektif olarak degerlendirildi. Biyopsi oncesi radyolojik bulgular manyetik rezonans goruntuleri kullanilarak arastirildi. Ameliyat oncesi ve sonrasi fonksiyonel sonuclar Ust Ekstremite Fonksiyonel Indeksi (UEFI), Alt Ekstremite Fonksiyonel Indeksi (LEFS) ve gorsel analog skala (VAS) kullanilarak degerlendirildi. Bu lezyonlarin marjinal ve genis rezeksiyonuna gore fonksiyonel sonuclar degerlendirildi. Bulgular: Preoperatif radyolojik bulgulara gore ince septa ile dev lipom veya dusuk dereceli liposarkom arasinda anlamli bir iliski yoktu. Ancak dusuk dereceli liposarkomda kalin septa ve globuler alan gorulmesi ile dev lipomlu hastalarda homojen kitle gorulmesi arasinda anlamli bir iliski vardi. Postoperatif orta donem UEFI, LEFS ve VAS skorlari marjinal ve genis rezeksiyon icin preoperatif fonksiyonel sonuclardan anlamli derecede daha iyiydi. Her iki lezyonun da marjinal ve genis rezeksiyonlarinda preoperatif ve postoperatif orta donem fonksiyonel sonuclari arasinda fark yoktu. Marjinal rezeksiyon yapilan dort dusuk dereceli liposarkom hastasinda lokal nuks tespit edildi. Sonuc: Calismada dusuk dereceli liposarkom icin kalin septum, globuler alan ve nonadipoz kitlenin, dev lipom icin de homojen kitlenin ayirt edici oldugu sonucuna varildi. Bununla birlikte dusuk dereceli liposarkomlarin genis cerrahi rezeksiyon ile tedavi edilmesi daha uygun olacaktir. Anahtar kelimeler: Dev lipom, iyi diferansiye liposarkom, cerrahi rezeksiyon, lokal nuks, fonksiyonel sonuclar