Primary gastric dedifferentiated liposarcoma resected endoscopically: A case report

BACKGROUNDLiposarcoma is one of the most common adult mesenchymal tumors but is uncommon in the gastrointestinal tract and extremely rare in the stomach. Furthermore, the histological subtypes of liposarcoma usually reported in the stomach are well-differentiated or myxoid, and few reports have been issued on small-sized gastric liposarcomas resected endoscopically and followed up. Herein, we report a case of primary gastric dedifferentiated liposarcoma (DL) that was resected endoscopically.CASE SUMMARYA 67-year-old female Korean patient was referred to our institution for further evaluation of a gastric submucosal tumor (SMT) located in the lesser curvature of the gastric body by esophagogastroduodenoscopy. Endoscopic ultrasound revealed a well-circumscribed, slightly heterogeneous, isoechoic, 17 mm × 10 mm sized mass originating from the third sonographic layer. Computed tomography showed no evidence of significant lymph node enlargement or distant metastasis. Endoscopic resection was undertaken using the snare resection technique after mucosal precutting to provide a definitive histopathologic diagnosis, which proved to be consistent with DL, based on its morphology and the immunoexpressions of MDM2 and CDK4. The patient was planned for surgery because the deep resection margin was positive for malignancy. After declining any invasive procedure or adjuvant treatment, the patient was placed under close follow-up, and at one year after endoscopic resection, remained disease free.CONCLUSIONThis is the first reported case of a small primary gastric DL resected endoscopically and followed up. This report demonstrates that when diagnosis of a SMT is uncertain, the use of invasive techniques, including endoscopic resection, should be considered.     

Hemoglobin,alkalic phosphatase,and C‐reactive protein predict the outcome in patients with liposarcoma

Data on prognostic biomarkers in soft tissue sarcomas are scarce. The aim of the study was to define prognostic markers in patients with a liposarcoma, a subtype of sarcoma derived from adipose tissue. We restrospectively reviewed 85 patients with liposarcoma treated at our department from May 1994 to October 2011. Kaplan–Meier curves, uni‐, and multivariable Cox proportional hazard models and competing risk analysis were performed to evaluate the association between putative biomarkers with disease‐specific and overall survival. We observed a significant association between both alkalic phosphatase (ALP; subhazard ratio [SHR] per 1 unit increase: 1.35; 95%CI 1.10–1.65; p = 0.005) and C‐reactive protein (CRP; SHR per 1 mg/dl increase: 2,57; 95%CI 1.36–4,86; p = 0.004) with disease‐specific survival. Hemoglobin (Hb) (HR per 1 g/dl increase: 065; 95%CI 0.48–0.87; p = 0.003) was associated with overall survival. These associations prevailed after multivariable adjustment for AJCC tumor stage. This study identifies CRP and ALP as novel independent predictors of disease‐specific survival in patients with liposarcoma. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:765–770, 2015.     

肾周脂肪肉瘤的诊断和外科治疗

目的 探讨肾周脂肪肉瘤的外科治疗方法。方法 总结分析2000—2006年间收治的28例肾周脂肪肉瘤病人经手术治疗的临床资料。结果 肾周脂肪肉瘤临床主要表现为进行性增大的腹部包块与消化道症状；起源于右肾周17例，左肾周11例。28例全部行手术切除。联合患侧肾脏切除19例，结肠部分切除10例，小肠部分切除8例，胃部分切除2例，脾切除2例，部分膈肌切除、胸腔闭式引流5例。平均输血1870mL。结论 手术切除是目前治疗肾周脂肪肉瘤惟一有效的方法，根治性手术必须包括肿瘤、肾脏和肾周脂肪囊在内的整块切除。     

Magnetic resonance imaging of myxoid containing tumors

Myxoid tissue forms part of many benign and malignant soft-tissue tumors. The advent of percutaneous needle biopsy has made it important to be aware of the diagnostic implications of biopsy samples containing myxoid tissue. To determine whether the magnetic resonance imaging (MRI) characteristics could help establish the diagnosis, we compared the MR images of 11 tumors containing myxoid tissue with the resected tumor tissue. In our small series of these rare tumors, the MRI characteristics allowed differentiation of intramuscular myxomas from malignant neoplasms containing myxoid tissue. Intramuscular myxomas meet the following conditions: (a) they are well circumscribed; (b) they arise within muscle; (c) T₁-weighted images demonstrate uniform, decreased signal intensity; (d) T₂-weighted images demonstrate uniform increased signal intensity; (e) contrast-enhanced images exhibit an inhomogeneous increase in signal intensity. If any of these conditions is not met, then a malignancy containing myxoid tissue should be suspected.     

双硫仑对人脂肪肉瘤细胞系SW872细胞的抑制作用及其机制

目的观察双硫仑(DSF)对人脂肪肉瘤细胞SW872的抑制作用,并探讨其相关分子机制。方法体外培养SW872细胞,设立正常细胞对照组及DSF 1,2.5,5和10μmol·L^-1组,采用CCK-8法检测药物处理24 h后对细胞增殖的抑制作用;光镜下观察DSF处理后SW872细胞形态变化;流式细胞术检测细胞凋亡;克隆形成实验检测DSF对SW872细胞克隆形成能力的影响;Western印迹法检测A20的表达;CCK-8法检测铁离子螯合剂Fer-1及炎症小体NLRP3抑制剂MCC950能否逆转DSF对SW872细胞的抑制作用;RT-PCR法检测DSF对SW872细胞中A20和醛脱氢酶(ALDH1)的mRNA水平。结果 DSF对SW872细胞增殖有显著抑制作用(P<0.01);DSF处理后使SW872细胞发生皱缩变圆且细胞间隙增大;DSF作用于SW872细胞24 h后,与正常细胞对照组相比,DSF 1μmol·L^-1组细胞早期凋亡率明显增加〔(32.6±1.82)%vs(3.50±0.64)%,P<0.05〕;DSF 0.1μmol·L     

腹膜后脂肪肉瘤CT诊断价值的研究

24例经手术确诊且CT检查资料完整的病例中,男10例,女14例。发病年龄45～78岁,平均年龄56岁,中位年龄58.5岁。其中发生于肾周围囊者13例,肾周围囊外11例。单发者22例,多发2例。肿瘤直径>10cm者23例,<10cm者1例。瘤体内含有脂肪组织密度者20例,其中10例呈均匀脂肪密度改变,9例可见脂肪组织与条片状或块状肌肉样组织混合存在,1例以肌肉样改变为主。肿瘤侵犯周围组织器官9例。回顾性分析结果显示,含有脂肪组织密度的巨大腹膜后肿块是诊断本病的可靠征象,CT扫描能准确地判断腹膜后肿瘤的大小、范围、术后复发及周围组织受侵程度等。     

Complete Response to Eribulin in a Patient with Unresectable Liposarcoma: A Case Report and Implications of New Biomarkers

We herein report a rare case of unresectable liposarcoma that showed a complete response to eribulin. Furthermore, a low expression of phosphorylated AKT (p-AKT) on an immunohistological evaluation was observed. This result is consistent with our previous preclinical study that demonstrated the significance of p-AKT signaling for eribulin resistance in multiple subtypes of soft tissue sarcoma (STS) cells. This case highlights the potential benefits of eribulin as well as the mechanism underlying resistance to eribulin in patients with unresectable or metastatic STS, especially liposarcoma.     

Primary Pleomorphic Liposarcoma of the Orbit: A Case Report

To our knowledge, pleomorphic liposarcoma (PL) of the orbit has only been reported in the literature four times. This rarity makes it more difficult to diagnose and to treat in this clinical setting. A 62-year-old female presented with pruritus, edema, proptosis and diplopia 5 months OS. Imaging revealed an intraorbital mass displacing the globe, with infiltration into the sinus. The tumor was removed and the histological examination revealed a highly cellular tumor with heterogenous histology, with a few vacuolated cells and many malignant features. Immunohistochemistry allowed for the differential diagnosis, resulting in a diagnosis of PL of the orbit. The cells were immuno-positive for S-100 and negative for all other relevant markers. According to the literature, prognosis for this neoplasm is quite poor, and exenteration represents the best treatment option. The patient refused exenteration and radiation therapy, however, at 2 year follow-up, she remained recurrence-free.     

多学科联合治疗巨大脂肪瘤部分肉瘤变1例

脂肪瘤和脂肪肉瘤均为临床常见肿瘤,然而腹膜后巨大脂肪瘤部分肉瘤变病例报道却较少,本治疗中心治疗1例腹膜后巨大脂肪瘤部分肉瘤变病例,反复发作并手术治疗,保留资料保存完整。现对此病例进行简要汇报并讨论。