Pulmonary pleomorphic liposarcoma

Pulmonary liposarcoma is extremely rare with 6 cases previously reported in the English literature. The following is a report of a 36-year-old man with pulmonary liposarcoma. The patient had chest pain and a mass shadow in the right lower lung field was revealed on a chest X-ray film. A computed tomography and magnetic resonance imaging showed a heterogeneous tumor, compressing the right lower lobe of the lung. Because of the fatty tissue component in the tumor on the chest computed tomography, and the appearance as an extrapulmonary mass, preoperative diagnosis was posterior mediastinal liposarcoma. But thoracotomy revealed that the tumor originated from the lung. Right lower lobectomy and lymph node dissection was carried out with no additional therapy. The pathological diagnosis was pleomorphic liposarcoma originated from the lung. Two months after the operation, the patient died of respiratory failure due to local recurrence.     

Inflammatory pseudotumor of the lung. An anatomoclinical study of a case report

One solitary pulmonary nodule was observed in a 47-year-old woman with history of right thigh liposarcoma 1 year before. Histological examination of the pulmonary specimen excluded liposarcoma metastasis and revealed an inflammatory pseudotumor. These unusual lesions with an excellent prognosis may exhibit, as in our case, atypical radiologic features and nuclear atypia, making the diagnosis difficult with malignancy.     

A case of leiomyosarcoma of the scrotum: chemotherapy with anti-cancer agents was effective for the lung metastasis

A 59-year-old male was referred to our hospital with the chief complaint of a painless scrotal mass. A 6 X 4.5 X 4 cm elastic hard mass with irregular surface was palpable in the right scrotum. We diagnosed a tumor in the right scrotum and resected the tumor surgically. Histopathologically, the tumor was liposarcoma of the right scrotum. Lung tumors were found 20 months after resection of the origin. Systemic chemotherapy with new anti-cancer agents (Paclitaxel and Gemcitabine) was performed. The main tumor was reduced to 56% in its diameter after 6 courses of chemotherapy. Exclusion of the right middle and lower pulmonary lobe was performed. The final pathological diagnosis of the lung tumor was metastatic liposarcoma.     

Giant cardiac metastasis of myxoid liposarcoma causing cardiac tamponade; report of a case

We report a very rare case of cardiac metastasis of myxoid liposarcoma. A 55-year-old man presented with dyspnea. Two and a half years ago, he underwent resection of myxoid liposarcoma in the left thigh. Magnetic resonance imaging (MRI) revealed a giant tumor occupying the pericardiac cavity and pressing the heart and consequently causing cardiac tamponade. The patient underwent surgery through a left thoracotomy approach. The pericardiac cavity was filled with a giant tumor with a stalk from the right ventricle and 2 small nodules on the main pulmonary artery. He was relieved from the symptom: however, he had a recurrence of the tumor at the same site 5 months after the operation. He underwent surgery for the removal of the second tumor; however, he died 49 days after the operation. Although cardiac metastasis is a very rare condition, its awareness is essential for careful long-term follow-up for the early detection of a metastatic cardiac liposarcoma after the resection of the primary tumor.     

Metastatic liposarcoma in the jejunum causing intussusception: Report of a case

We report a case of metastatic liposarcoma in the jejunum manifesting as intestinal intussusception. A 75-year-old man underwent wide excision of a dedifferentiated liposarcoma in his left thigh, followed by adjuvant radiation therapy. He was referred to our department 7 months later with colicky abdominal pain and vomiting. Abdominal radiography showed an intussusception of the small intestine. Laparotomy revealed an antegrade jejunojejunal intussusception, and we resected the jejunum containing the tumor without attempting manual reduction. Histological examination confirmed that the tumor was a metastasis of the liposarcoma. The patient died of pulmonary metastasis 3 months later.     

Pulmonary metastasis with left intra-atrial extension of liposarcoma. Apropos of a case

The direct extension of a neoplastic thrombus of the pulmonary veins into the left atrium is extremely rare. The authors report the case of a pulmonary metastasis from a liposarcoma of the thigh extending into the pulmonary veins and prolapsing into the left atrium. The patient was successfully treated by tumorectomy under cardiopulmonary bypass then by left upper lobectomy.     

Primary liposarcoma of the thoracic spine: case report

Liposarcoma is a malignant tumor of soft tissue. The thoracic spine is an unusual location, even for metastasis, and to our knowledge, no case of primary pleomorphic liposarcoma of the vertebral body has been reported until now. A female patient presented with paraplegia. She had a previous medical history of mental depression, and complained of dorsal pain for three months following a road accident. Magnetic Resonance Imaging (MRI) revealed a collapse of T7-T8, and the diagnosis of plasmocytoma was made. She was treated with decompressive laminectomy and posterior instrumentation. Histological examination revealed a pleomorphic liposarcoma. She received a course of radiotherapy. At 13 months follow-up she developed pulmonary metastases and rib involvement. The spine is an unusual location for pleomorphic liposarcoma, even as metastasis. The differential diagnoses of this rare entity are discussed, as well as the criteria for diagnosing primary spinal liposarcoma. Although rare, our case demonstrates that liposarcoma should be considered in the differential diagnosis of spinal tumors.     

Midterm results after treatment of liposarcoma in the extremities

PURPOSE: In this retrospective analysis, survival time, local recurrence and rate of metastasis were appraised in patients with primary liposarcoma of the extremities depending upon the applied primary and adjuvant therapy procedures. Furthermore, we compared the representativity of histological results of the biopsy with the final histology of the resected tumour. MATERIAL AND METHOD: Between 1990 and 1998, 27 patients were surgically treated who suffered from a primary liposarcoma of the extremities. At the mean follow-up time of 62.4 months (39-141 months) postoperative survival rate, rate of metastasis and local recurrence were determined. The results were analysed with regard to intraoperative resection distance, tumour size and localisation as well as histological classification of previous biopsy and finally resected tumour. The influence of radiotherapy on the results was also determined. RESULTS: In 5 patients (18.5%) the amputation and in 22 cases (81.5%) the limb sparing resection of the liposarcoma was performed. 6 patients underwent a marginal resection and one patient an intralesional resection. At follow-up we observed a local recurrence rate of 22.2% (n = 6) and a survival rate of 74.1%. 18.5% of the patients had metastases. After adjuvant radiotherapy three patients (50%) showed local recurrence after marginal resection. In only 8 cases (29.6%) the results of primary biopsy and final tumour classification (entity, subtype and grading) were identical. CONCLUSION: The development of metastases (often pulmonary) and local recurrences even after long tumour-free interval makes adequate follow-up investigations mandatory in liposarcoma patients. With regard to the problems in assessing liposarcoma biopsies, MRI-orientated biopsies from several tumour areas via one biopsy approach are recommended.     

A case of retroperitoneal dedifferentiated liposarcoma initially diagnosed as malignant fibrous histiocytoma: a case report

We report a case of retroperitoneal tumor which turned out to be liposarcoma by the histological evaluation of its recurrent tumor, although the initial tumor was diagnosed as malignant fibrous histiocytoma (MFH). A retroperitoneal tumor in a 62-year-old man was removed and pathologically diagnosed as MFH. Five years after the initial surgery, computed tomography (CT) demonstrated a recurrent tumor near the spleen. The tumor was resected together with the spleen, tail of pancreas, and connective tissue due to adhesion and diagnosed as well-differentiated liposarcoma with sclerosing component. Generally dedifferentiated liposarcoma is difficult to distinguish from MFH and the presence of a well-differentiated liposarcoma component in the adjacent adipose tissue leads to the diagnosis of dedifferentiated liposarcoma. The clinical course of the present case indicated that the initial tumor was dedifferentiated liposarcoma and the recurrent tumor developed from the surrounding well-differentiated liposarcoma.     

Liposarcoma of the transverse mesocolon--a case report]

Primary mesenteric liposarcoma is a rare neoplasm. We experienced a case of liposarcoma of transverse mesocolon. In our case, the examination of ultrasonography and CT scan revealed the tumor was solid and encapsulated. Preoperatively we suspected the tumor was malignant by the angiographic findings. Laparotomy revealed that the tumor was located in the transverse mesocolon and it could be removed easily. The histopathological diagnosis was myxoid type liposarcoma. It is said generally that liposarcoma is liable to recur after simple resection, therefore, we reconsider that we should have excised more extensively for this case. The patient is doing well without evidence of recurrence for 17 months after operation.     

Liposarcoma simulating a Baker's cyst: a case study

We present a case of liposarcoma in a 65-year-old man in whom the tumor first appeared as a soft, cystic mass at the medial margin of the left popliteal fossa. The mass simulated a Baker's cyst. The patient remained untreated for almost 7 months from the discovery of the mass. With worsening pressure symptoms, a biopsy was done that confirmed the clinical diagnosis of liposarcoma. The leg was amputated, but the patient died 2 years later with clinical evidence of pulmonary metastasis. By presenting this case report, we stress the importance of carefully investigating for malignancy all masses presenting as a Baker's cyst in persons past middle age.     

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.     

Formation of the 12q14-q15 amplicon precedes the development of a well-differentiated liposarcoma arising from a nonchondroid pulmonary hamartoma

Pulmonary hamartoma is a benign neoplasm that rarely recurs or undergoes malignant transformation. Herein, we report a 48-year-old woman with a history of an incomplete excised nonchondroid pulmonary hamartoma presenting as an indolent tumor recurrence. Excision of the tumor revealed a well-differentiated liposarcoma arising from the hamartomatous component. Fluorescence in situ hybridation analysis for HMGA2 and MDM2 was performed on both hamartomatous and liposarcomatous component. MDM2 and HMGA2 amplification were found in a subset of stromal cells in the hamartomatous component and in most cells of the well-differentiated liposarcoma. No rearrangement HMGA2 was found in the pulmonary hamartoma component. These findings suggest that the formation of the 12q14-q15 chromosome amplicon, the characteristic cytogenetic finding of well-differentiated liposarcomas and the structural genomic component of the supernumerary ring and giant rod chromosomes, occurred before the morphologic changes characteristic of these malignant adipose tissue tumors and likely represents a very early molecular event in their development.     

Successful Resection of a Recurrent Mediastinal Liposarcoma Invading the Pericardium: Report of a Case

Primary liposarcoma of the mediastinum is rare, but cases of recurrence have been reported in the English literature. We successfully resected a recurrent pericardial liposarcoma, detected 5 years after the initial resection of a liposarcoma of the anterior mediastinum invading the pericardium. Routine follow-up computed tomography showed the recurrence and suggested invasion of the pericardial cavity, which was supported by the findings of transesophageal ultrasonography. As cine-magnetic resonance imaging suggested that the tumor was resectable, an operation was performed. Histopathology confirmed the diagnosis of recurrent liposarcoma and showed clear surgical margins.     

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.     

Giant liposarcoma of the esophagus with Li-Fraumeni-like syndrome

Primary esophageal liposarcoma is a rare malignancy, with only 25 cases reported in the English literature. In this report, we present a new case of giant esophageal liposarcoma in a 49-year-old woman with a family history of upper gastrointestinal tract cancer. This was a transmural tumor located in the lower esophagus. Subtotal esophagectomy was successfully performed, and histopathology revealed a well-differentiated liposarcoma. The patient was followed-up for 20 months without recurrence. However, asynchronous ovarian serous adenocarcinoma was found 1 year after the esophageal surgery, and Li–Fraumeni-like syndrome was diagnosed.     

腹膜后脂肪肉瘤的生物学特性及其诊断和治疗

目的 探讨腹膜后脂肪肉瘤生物学行为及诊断与治疗的有关问题。方法 回顾性分析1970—2005年中国医科大学附属第一医院收治的32例（共接受手术43例次）原发及复发腹膜后脂肪肉瘤病人的临床和病理资料。结果 该病主要临床表现是腹胀、腹部包块进行性增大。复发病例较原发病例生物学行为差，肿瘤侵袭力强，组织学亚型恶性程度高，手术完全切除率低。多次复发者复发间期逐渐缩短。难治性大出血是术后主要且致命的并发症。结论 腹膜后脂肪肉瘤术后易复发，很少转移，手术切除是最有效的治疗手段。完全切除者复发间期长，控制术中出血是减少术后死亡的关键。放、化疗对腹膜后脂肪肉瘤的作用有限。     

Recurrent mediastinal liposarcoma twenty years after the initial operation: case report

We report a case of mediastinal liposarcoma, recurrent after 20 years. A 58-year-old man who presented with dyspnea on exertion was found to have a large mediastinal tumor in chest computed tomography (CT), and he was referred to our hospital. He had undergone an extirpation of a mediastinal liposarcoma about 20 years earlier, and we suspected its recurrence. Because the tumor was very large, it was removed in two stages. Histologically it was diagnosed as a recurrence of the previous well-differentiated liposarcoma. Although liposarcoma is one of the most common soft-tissue sarcomas in adults, a mediastinal liposarcoma is rare. Because the recurrence rate is very high, it is necessary to follow up carefully over a long term.     

Multifocal liposarcoma showing rapid growth in a short term: a case report

We report a case of multifocal liposarcoma that showed rapid growth in a short term. A 65-year-old male was referred from a local doctor to our clinic with the chief complaint of abdominal fullness. Abdominal CT shows two huge tumors in the intraperitoneal and retroperitoneal space, and we diagnosed it as multifocal liposarcoma. Both tumors were resected. The surgical specimens of intraperitoneal and retroperitoneal masses were 20 x 10 cm and 12 x 8 cm in size, and 3.5 kg and 2.8 kg in weight, respectively. Histological diagnosis of both tumors was myxoid liposarcoma. However, the tumor recurred 4 months later, and two additional operations were required because of rapid growth. The patient died at 7 months after the first admission. The clinical outcome of myxoid liposarcoma is known to be better than other histological types, but it is very poor when the tumor appears multifocally.     

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

A case of gigantic liposarcoma of the breast in a 52-year-old woman was reported. She had a small indolent mass in the left breast for twenty years. The mass grew rapidly from the summer of 1979 and became gigantic and penetrated the skin over the mass. Her general condition on admission was poor but resection, of the tumor was carried out. She suddenly died of cardiac failure with electrolytes imbalance 13 days after the operation. The diagnoses of liposarcoma, predominantly myxoid, was made on the basis of light and electron microscopic findings. Forty cases of liposarcoma of the breast were collected from the literature. The possibility of malignant trans-formation of a benign tumor was suggested.