再発をくり返した下咽頭脂肪肉腫例

Abstract

We report a case of liposarcoma of the hypopharynx in a 76 year-old male that recurred repeatedly and was associated with histological changes over a period of 10 years. The initial histological diagnosis was a tumor of the well-differentiated type, and the patient underwent simple extirpation via lateral pharyngotomy. Eight years after the original surgery, lateral pharyngotomy was repeated for resection of a recurrent tumor, which proved to be of the dedifferentiated type. Two years after the second surgery, the tumor recurred again, growing more rapidly, and the patient displayed dyspnea and dysphagia. CT scans and MRI findings revealed a large hypopharyngeal tumor expanding from the mesopharynx to the cervical esophagus. The patient subsequently underwent pharyngolaryngoesophagectomy combined with free jejunum transplantation. The resected tumor was histologically diagnosed as myxoid in type.Most liposarcomas of the hypopharynx are histologically low-grade malignancies, patients with this disease often survive for years. However, in cases of recurrence, the histological features of the tumor occasionally change to higher-grade malignant types. In view of this possibility, complete surgical excision is very important in the initial treatment of liposarcoma, and physicians should not hesitate to perform wide excision in cases of recurrence.