A Case of Liposarcoma With Peritonitis Due to Jejunal Perforation

[摘要] A 21-year-old man, who had been treated for congenital dilatation of the bile duct 13 years previously, presented with anacute abdomen. The physical examination suggested peritonitis, and an emergent laparotomy was performed. A perforationwas foundin the jejunum approximately 100 cm distal to the ligament of Treitz, followed by resection of a 60-cm jejunalsegment. No tumorous lesions were found during the operation, and the resected jejunal segment showed only focalmyxomatous thickening of the serosa. Despite intensive therapy, he died of uncontrollable septic shock 2 days after theoperation. Unexpectedly, however, histological examination revealed a liposarcoma, showing an unclassifiable histology.From the distribution of the lesion and the histological findings, it is thought that a primary lesion was somewhere else,covered by severe adhesions due to the previous operation, and that the tumor cells spreading from it could have caused thejejunal perforation through vascular involvement. Although extremely rare, liposarcomas in the abdomen can cause intestinalperforation. It is important for both clinicians andpathologists to carefully investigate the cause of an unusual clinicalpresentation such as intestinal perforation.

[学科分类] 肿瘤学