Liposarcoma of the breast: a case report and review of the literature

Sarcoma of the breast constitutes <1% of all malignant breast tumors, and liposarcoma of the breast represents 3-24% of the primary breast sarcomas. We report a case of a 74-year-old woman presenting with liposarcoma of the left breast. The patient presented with a fibrous and hard mass measuring approximately 10 x 5 cm in diameter in the upper part of the left breast. Aspiration breast cytology showed inflammatory changes and had no malignant element. Differential diagnosis with sonography, computed tomography, and magnetic resonance imaging was not successful. A wide excision was performed with a 2-cm margin of healthy tissue. The tumor was diagnosed histologically as a well-differentiated liposarcoma (sclerosing type). The patient was discharged and her recovery was uneventful. We report a case of liposarcoma of the breast and discuss this rare malignant tumor and other types of sarcoma of the breast in light of the previously published literature.     

The retroperitoneal liposarcoma: a case report

A 62-year-old woman was admitted to our hospital because of a mass in the right abdomen. Ultrasonography, aortography and computed tomographic (CT) scanning revealed the right kidney displaced by a huge and avascular mass containing fatty tissue. Also magnetic resonance imaging (MRI) indicated that it was contained of lipomatous tissue and demonstrated the mass occupying the entire right abdominal cavity. The tumor including the right kidney was resected, following diagnosis of the retroperitoneal tumor. The exercised tumor measured 28 X 22 X 18 cm and weighed 2,010g. The histological diagnosis was well-differentiated liposarcoma. She has been healthy for three months following postoperative chemotherapy. Many reports have been made on the ultrasonographic and CT appearance of retroperitoneal liposarcoma, but few have been made on the MRI appearance. According to our case, imaging diagnosis by MRI also seems to be useful in making a histological diagnosis of liposarcoma.     

A case of metachronous, multifocal development of liposarcoma in the back of left thigh, the left subclavicular region and the right perirenal tissue

A 46-year-old woman had received surgery to remove a mass arising from the back of the left thigh 13 years before and on the left subclavicular region 3 years before. Histological diagnosis of both masses was myxoid type liposarcoma. She was admitted to our hospital because of right abdominal pain. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of a large retroperitoneal tumor. The removed specimen weighed 1,450 g and measured 24 x 13 x 9 cm in size. Histological diagnosis was myxoid type liposarcoma. She has been free of any recurrence for 4 months postoperatively without adjuvant therapy.     

Mediastinal liposarcoma appearing as a tumor arising in the esophageal wall

We report a case of mediastinal liposarcoma, a relatively uncommon neoplasm, in which the mass also appeared as a tumor arising in the esophageal wall. A 76-year-old man diagnosed with a posterior mediastinal mass had the tumor extirpated in local esophageal myectomy due to its unclear margin on the esophageal wall. The resected specimen was diagnosed as well-differentiated liposarcoma. Preoperative angiography showed the tumor received its blood supply from a branch of the left gastric artery, suggesting it arose in the lower esophageal segment close to the hiatus and extended to the mediastinum. Since this tumor's growth pattern differed completely from esophageal liposarcoma described in previous case reports, we concluded that it was mediastinal liposarcoma.     

Primary Cardiac Liposarcoma Causing Cardiac Tamponade: Report of a Case

The intracardiac growth and extension of liposarcoma was observed in a 60-year-old woman. The epicardial tumor was identified to originate from the anterior wall of the right ventricle. She initially showed symptoms associated with cardiac tamponade. A surgical operation was performed but it resulted in incomplete resection due to massive invasion and dissemination. The recurrence of the tumors led to congestive heart failure. Finally, she died of heart failure and liver dysfunction as a result of tumor metastasis and invasion. An autopsy detected the primary cardiac liposarcoma. Only a few cases of cardiogenic liposarcoma have so far been reported. A further elucidation of cardiac liposarcoma could reveal mechanisms of the disease, and thus contribute to development of complementary therapies after surgical intervention.     

Metastatic liposarcoma of the brain with response to chemotherapy: case report

Metastatic liposarcomas to the brain are rare. The authors describe a patient with a 20-year history of liposarcoma originating in the thigh and metastatic to the brain 18 years later. The brain metastasis was removed by surgery. Nine months later, the patient developed metastases to the retroperitoneum and liver. At that same time, she had recurrent brain metastasis. She was then treated with chemotherapy. The abdominal mass shrank considerably in the beginning, and the recurrent brain metastases totally disappeared. The patient eventually succumbed to widespread liposarcoma. Autopsy revealed extensive liposarcoma involving the retroperitoneum, liver, and lung, but no trace of tumor was found in the brain.     

Retroperitoneal liposarcoma in a child.

Retroperitoneal liposarcoma is a rare tumor in children and has been reported previously on only three occasions. This is the fourth such case, presenting with a large mass on the left side which displaced the sigmoid and ureters to the right. The patient was treated with surgery, radiotherapy, and chemotherapy. She is alive and well more than four years after therapy was instituted. A review of the pertinent literature cites the need for radio- and chemotherapy especially when surgical removal is incomplete.     

Metaplastic spindle cell carcinoma of the breast in a patient with neurofibromatosis type 1

We report a unique case of a 67‐year‐old woman with neurofibromatosis type 1, who was also diagnosed with metaplastic spindle cell carcinoma of the left breast. She had many neurofibromatosis lesions on her body, as well as the mass in the left breast. After the breast mass was diagnosed as a malignant mesenchymal tumor by core needle biopsy, the patient underwent left modified radical mastectomy. Subsequently, the pathological analysis of the tumor showed it to be a metaplastic spindle cell carcinoma. The co‐occurrence of neurofibromatosis type 1 and breast cancer, in particular metaplastic spindle cell carcinoma, is very rare.     

Giant primary liposarcoma of the chest

Liposarcomas are the most common soft tissue sarcomas in adults, although liposarcomas of the chest are uncommon. We report two cases of giant liposarcoma in the mediastinum and chest wall, respectively. An 82-year-old man presented with a mass in the right upper mediastinum, as seen by computed tomography (CT). He had a past history of subcutaneous lipoma resection on his back (19 years previously). The patient underwent tumor resection with a right thoracotomy. A 58-year-old woman presented with an enlarging mass of the right lateral chest, involving the diaphragm and ribs, as seen by CT. She had a past history of subcutaneous lipoma resection of the right chest (18 years previously). The patient underwent an en bloc resection that included the tumor and a part of the right diaphragm and ribs. Histological examination of both patients’ tumors revealed a well-differentiated liposarcoma, with no pathological relation to the previous lipoma resected in either case.     

A case of inflammatory myofibroblastic tumor of the retroperitoneum

Here we report a rare case of inflammatory myofibroblastic tumor of the retroperitoneal space. A 46-year-old woman had had microscopic hematuria for 5 years. Ultrasonographic examination for screening revealed two solid tumors adjacent to the right kidney. These tumors were suspected to be malignant fibrous histiocytoma or liposarcoma by computed tomography and magnetic resonance imaging. She underwent resection of these retroperitoneal tumors and additional right nephrectomy because these tumors were adhered to the kidney and liposarcoma was highly suspected on frozen sections. Histopathologic examination finally revealed that the tumors were inflammatory myofibroblastic tumor arising within Gerota's fasia. She has been followed up for 9 months without any evidence of local recurrence.     

A myxoid liposarcoma in the lower leg, with a large intra-abdominal metastasis

We report a patient with a large intra-abdominal metastasis of myxoid liposarcoma. The patient first noticed an asymptomatic mass in her left leg in 1985, when she was 20 years old. The mass was left untouched until she realized its rapid growth and consulted a local doctor in 1994. After needle biopsy, she was histologically diagnosed as having a myxoid liposarcoma. She disagreed with the recommendation for an amputation below the knee, made at another hospital. A marginal resection was performed as an alternative treatment. She subsequently underwent three more marginal resections and four intra-lesional resections for repeated local recurrences. In 1997, an abdominal computed tomography scan revealed the presence of multiple intra-abdominal metastases, and the lesions were judged to be inoperable. Ileus and respiratory distress, caused by compression by the abdominal mass, gradually worsened, and she died in 1999, at the age of 34. The girth of her abdomen was 135 cm at the time of death. Received: May 11, 2000 / Accepted: September 12, 2000     

A case of a large retroperitoneal liposarcoma presenting as an incarcerated inguinal hernia

We report a rare case of retroperitoneal liposarcoma developing within an incarcerated inguinal hernia. A 53-year-old man presented to our hospital with left inguinal mass. Preoperative computed tomography revealed an intraabdominal huge mass, and a clinical diagnosis of liposarcoma. Physical findings except for the inguinal mass and laboratory examination, including tumor markers (CEA, CA19-9), were within normal range. Intraoperatively, the mass was incarcerated in the inguinal canal and involved the left testis. We performed a radical tumor resection, including a left orchiectomy. The resected specimen measured 45 × 30 cm and weighed 7,510 g. Histopathologically, the tumor was diagnosed as a well-differentiated liposarcoma, and originated from retroperitoneum. We did not undergo adjuvant therapy in consideration of histopathological subtype and curable surgical treatment. The patient is well and shows no evidence of recurrence four months after the operation.     

Successful removal of a giant recurrent mediastinal liposarcoma involving both hemithoraces.

Primary liposarcomas of the mediastinum are unusual tumors. We report herein a case of a 52-year-old woman, who was found to have a mediastinal tumor involving both hemithoraces and radiologically showing non-resectable-invasive features to the adjacent vital structures. She had a history of left thoracotomy for mediastinal schwannoma 14 years previously. The patient underwent an exploratory thoracotomy following a preoperative misdiagnosis of an ancient schwannoma. Complete removal of the tumor was accomplished through a right posterolateral thoracotomy with a subsequent histological diagnosis of a recurrent low-grade liposarcoma. A resectable liposarcoma should be considered in the differential diagnosis of a mediastinal tumor, although radiologically, the tumor presents with invasive features.     

Dedifferentiated Liposarcoma of the Pleura: Report of a Case

We report a case of dedifferentiated liposarcoma of the pleura in a 59-year-old man who presented with pain in the right chest wall, 3 years after a routine chest X-ray showed a large tumorous mass. The resected tumor was composed of three distinct histological features: well-differentiated liposarcoma with low-grade leiom-yosarcomatous and low-grade osteosarcomatous components. To our knowledge, this is the first report of dedifferentiated liposarcoma of the pleura.     

Laparoscopic Resection of a Retroperitoneal Liposarcoma: A Case Report and Review of the Literature

Here, we describe a case of a retroperitoneal liposarcoma successfully managed by laparoscopic surgery. A 72-year-old man underwent abnormal hypertension screening using computed tomography (CT), which revealed a low-density mass measuring 7 cm in diameter in the retroperitoneal space. We diagnosed the mass as a liposarcoma before the operation. The mass was resected laparoscopically. No perioperative complications were encountered, and the patient was discharged on the fourth postoperative day. The pathologic diagnosis was well-differentiated liposarcoma, indicating complete surgical resection. Thus, we conclude that a laparoscopic approach for the patients with retroperitoneal tumors, including liposarcomas, is safe, feasible, and minimally invasive, even if there is a possibility of the tumor being malignant.     

Liposarcoma of the spermatic cord associated with rectum cancer: a case report

We report a case of liposarcoma of the spermatic cord associated with rectum cancer. A 78-year-old man visited our hospital with a complaint of painless left inguinal mass. He also showed constipation and bloody bowel discharge, rectum cancer was diagnosed by further evaluation. Ultrasonography, computed tomography and magnetic resonance imaging revealed a 2 x 4 x 6 cm mass in the left spermatic cord. Left high orchiectomy for the left inguinal tumor and Hartmann's procedure for rectum cancer was performed. Histologically, the mass in the left spermatic cord was well differentiated liposarcoma and rectum cancer was poorly differentiated adenocarcinoma. He died from rectum cancer with no evidence of recurrence of liposarcoma of the left spermatic cord after follow up for 6 months.     

Primary osteogenic sarcoma of the breast. Report of a case

Primary osteogenic sarcoma (POS) of the breast is very rare. Only eleven cases have been previously reported in Japan. In this paper, we report an additional case of POS. A 30 year old female was admitted to our hospital with chief complaint of rapidly growing mass of the right breast. She was diagnosed carcinoma of the right breast and underwent a radical mastectomy (Br + Ax + Mj + Mn). Histological findings of the resected tissues revealed POS of the breast. After three months from the operation, local recurrence was demonstrated by an incisional biopsy. One more months later, chest X-P revealed bilateral lung metastases. Irradiation with 60Co for recurrence and chemotherapy using vincristine, methotrexate for distant metastases were not effective. However, cisplatin caused the necrosis of local recurrent tumor. She died nine months after operation. At autopsy, extended metastasis of tumor cells diffusely to the pleura, lungs, liver, adrenal glands, pancreas, peritoneum, fifth lumbar vertebra, skull, dura mater and left pulmonary hilar lymph nodes was observed.     

Breast Enlargement After Two Reduction Mastoplasties: A Case Report

In 1989, a bilateral breast reduction was performed for a large-breasted woman. She returned 1 year later with bilateral breast enlargement as severe as in the original case. The operation was repeated but in a more aggressive way. She became pregnant 2 years later, and both her small breasts began to grow again until they became gigantic. Hormonal tests showed results within the standard limits, and no medical treatment was effective. After the delivery, her breasts reduced in size spontaneously.     

Retroperitoneal liposarcoma: a report of 2 cases and review of 163 cases in Japan

Two cases of retroperitoneal liposarcoma are reported. Case I was a 71-year-old-male presenting with a mass in the left abdomen. On X-ray examination, a large extrarenal tumor was found in the left retroperitoneal space. The tumor appeared to invade the psoas muscle and the aorta. Exploratory laparotomy was carried out. The histological diagnosis of the tumor was myxoid-type liposarcoma. He died of the disease. Case 2 was a 44-year-old-male who presented with a mass in the left abdomen. On X-ray examination, a large tumor was found in the left retroperitoneal space, and left kidney and the descending colon were markedly displaced by the tumor. Excisional surgery was carried out. The tumor was almost completely removed. The histological diagnosis was myxoid-type liposarcoma. A combination chemotherapy (actinomycin D, vincristine, cyclophosphamide) was started. but soon switched to radiation therapy because of liver dysfunction. Four months following the operation, there is no evidence of residual disease. One hundred sixty three cases of retroperitoneal liposarcoma reported in Japan are reviewed.     

Use of the oncoplastic reduction pattern technique following removal of a giant breast lipoma

We present a case report of a 59-year-old patient with a giant lipoma of the left breast, extending to the left arm. She sought medical consultation because it had become heavy and caused pronounced breast asymmetry. The lesion was excised by means of an oncoplastic technique using the superior-medial pedicle wise-pattern breast reduction approach. We concluded that the use of the oncoplastic reduction pattern technique after removal of a giant breast lipoma is highly rewarding, resulting in a smaller-sized breast that is aesthetically more pleasing, has better symmetry with the contralateral breast, and provides relief from functional mass deficit. This technique minimizes the potential for a breast deformity once the tumor is resected.