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1 典型病例例1女,41岁,两个月前左足扭伤后,足底轻度肿胀,疼痛,未经诊治.现肿胀逐渐加重,疼痛加剧且负重时显著.X线片示:左足近跟骨足底部见一软组织肿块,高密度影,形如鸡卵,跟骨部骨质密度减低.足CT扫描:左足底跟部肿块伴跟骨内缘骨质破坏,吸收,多考虑偏恶性肿瘤可能.外科所见:左足底足跟前内侧可见局部肿胀约4cm×4cm×3cm大小,局部皮肤无红肿及静脉怒张,局部压痛(+),肿物质韧,活动度差,左足末稍感觉及运动无明显异常改变.组织穿刺活检:查及恶性肿瘤细胞.行单纯肿瘤切除术.病理所见:肉眼送检不整形组织一块,上附少许肌肉组织,体积5cm×4cm×3cm,剖面实性灰白色,鱼肉状.镜下:瘤细胞形成实性片块状部分区域见腺泡状结构,瘤细胞巢之间有丰富的血窦(见附图),PAS(+).病理诊断:左足部腺泡状软组织肉瘤.术后一个月,切口仍不断涌出淡粉色清稀液体.临床认为病灶切除后足跟部形成一空腔新鲜肉
1 typical case 1 female, 41 years old, two months before the sprained left foot, sole swollen mildly, pain, without treatment. Now the swelling is getting worse, the pain is worse and the weight is significant. X-ray film shows: the left foot near the A soft tissue mass was seen at the bottom of the bone foot. The high-density shadow was shaped like a chicken egg and the bone density of the calcaneus was reduced. The CT scan of the foot: the heel of the left heel was accompanied by destruction of bone in the inner edge of the calcaneus, absorption, and more consideration was given to malignant tumors. Possible. Surgical findings: local swelling of the left foot plantar hemisphere can be seen in the size of about 4cm × 4cm × 3cm, local skin no swelling and venous engorgement, local tenderness (+), swelling of the material tough, poor activity, left foot and feel the end No significant abnormalities in movement. Tissue biopsy: To investigate malignant tumor cells. To undergo simple tumor resection. Pathological findings: The naked eye is not a piece of plastic tissue, with a little muscle tissue, the volume of 5cm × 4cm × 3cm, solid section Off-white, fish-like. Microscopically: Tumor cells form a solid mass with partial alveolar structure. There are abundant sinusoids between the nests of tumor cells (see attached). PAS(+). Pathological diagnosis: left foot Alveolar soft tissue sarcoma. One month after surgery, the incision is still pouring pale pink clear liquid. After a tumor resection cavity formed heel portion of fresh meat