The patient came
clinic 01-November-2006 complaining of growing mass in the
left lumbo-sacral area for 3 years with ulceration of the mass
in the last months.
Neurologic and systemic examination was uneventful, except for
gout and arterial hypertension. The patient was sent for
investigations to rule out mts. Abdomino-pelvic CT-scan and MRI of
the lumbar spine ruled out presence of metastases and involvement of
the subcutaneous layer under the mass, which measured 20x20 cm in
dimension. High index of malignant nature of the mass was considered
and the mass with safety margin was resected in toto, trying not to
contaminate the wound with ulcerative part of the mass. The
dissection was carried out to the sheath, which was anatomically
normal. Routine closure of the wound.
1. Progression of the mass and ulceration and characteristic
for malignant nature of the mass and complete removal with safety
margin is the only choice for cure. The preliminary diagnosis is
exophytic malignant lipofibroma.