Critical histopathological analysis of 25 dedifferentiated liposarcomas, including uncommon variants, reviewed at a Tertiary Cancer Referral Center

Rekhi, Bharat; Navale, Pooja; Jambhekar, NA

doi:10.4103/0377-4929.101733

Cited by 20 publications

(24 citation statements)

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“…Chromosomal analysis of 12q15 amplification, which yields positive results in 90 % of cases of WDLS/DDLS, 17,18 was performed on eight percutaneous biopsy specimens as part of the pathologic examination. Seven had positive results for 12q15 amplification (sensitivity for WDLS/DDLS detection, 87.5 %); all eight specimens, including the case with negative results for 12q15 amplification, were diagnosed as either WDLS or DDLS (the patient with negative results for 12q15 had a history of recurrent WDLS).…”

Section: Resultsmentioning

confidence: 99%

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

et al. 2014

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Background Surgery is the primary treatment for all subtypes of retroperitoneal liposarcoma, but neoadjuvant therapy may be warranted in cases of dedifferentiated liposarcoma (DDLS), which has an increased risk of recurrence and metastasis. Therefore, an accurate subtype-specific diagnosis is vital for appropriate consideration of neoadjuvant therapy. Previous studies assessing the subtype-specific accuracy of percutaneous biopsy are limited. We aimed to analyze the accuracy of preoperative percutaneous biopsy in the subtype-specific diagnosis of retroperitoneal liposarcoma and thus the reliability of percutaneous biopsy in guiding decisions about neoadjuvant treatment. Methods We retrospectively reviewed the medical records, including the pathologic reports, interventional radiology reports, and operative reports, of patients registered in the retroperitoneal/well-differentiated liposarcoma (WDLS/DDLS) database at The University of Texas MD Anderson Cancer Center between 1993 and 2013. Results We identified 120 patients who underwent 137 preoperative percutaneous biopsies followed by surgical resections. Pathologic examination following resection indicated that 74 of the patients had WDLS and 63 had DDLS. The overall diagnostic accuracy of percutaneous biopsy for identifying the subtype of liposarcoma was 62.8 % (86/137); the accuracy for identifying WDLS was significantly higher (85.1 %; 63/74) than that for identifying DDLS (36.5 %; 23/63) (p < 0.01). Conclusions Percutaneous biopsy has low accuracy in the diagnosis of retroperitoneal DDLS. This can potentially mislead physicians in the decision to implement neoadjuvant treatment. When developing treatment strategies, including clinical trials for patients with retroperitoneal liposarcoma, physicians should carefully consider the low accuracy of percutaneous biopsy in detecting DDLS.

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Section: Resultsmentioning

confidence: 99%

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

et al. 2014

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“…A Critical histopathological analysis of dedifferentiated liposarcomas revealed that CD34 was negative in 9/11 cases; negative rate of s-100 was 92% (23/25); MDM2 was diffusely positive in well-differentiated areas and focally in dedifferentiated areas in the tumor with homologous dedifferentiation; SMA was positive in 2/8 tumors (24). Andrei et al proved that MDM2 and CDK4 were significative markers for confirming the diagnosis of well-differentiated liposarcoma (23).…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, differentiated sarcoma can be subdivided into five main subtype: Resembling pleomorphic malignant fibrous histiocytoma, fibrosarcoma, rhabdmyofibrosarcoma, myxofibrosarcoma and hemangiopericytoma (25,26). A total of 76% of dedifferentiated liposarcomas was high-grade (24).…”

Section: Discussionmentioning

confidence: 99%

Giant paratesticular liposarcoma: A case report and review of the literature

Zhou

Zhao

et al. 2018

mol clin onc

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Abstract. Paratesticular liposarcoma is an infrequent tumor characterized by a growing, painless, inguinal or scrotal mass. Only about 200 cases have been reported as of yet in literature, however there are a few cases regarding giant paratesticular liposarcoma measuring over 10 cm. The disease may be commonly misdiagnosed prior to operation. Improper treatment tends to lead to local recurrence and distant metastasis. The current report presents a case of a 51-year-old patient with a large, painless right scrotum. Magnetic resonance imaging revealed a 7.8x5.8x10.4 cm nonhomogeneous space-occupying lesion of the right testis, which was firstly diagnosed as a spermatocytoma. Following this, a radical orchiectomy of the right testis was performed, however, it appeared to be a dedifferentiated liposarcoma, following histopathological examination and immunohistochemistry. Due to the large size of the tumor, it is significant to report the characteristics, diagnosis and treatment of the similar cases. The current study additionally presents a supplementary review of previously published cases in literature and focuses on discussion regarding the clinical characteristics, diagnosis, histopathology and immunohistochemical features and treatment of this disease. IntroductionLiposarcoma, a malignant tumor derives from mesodermal tissues, represents ~20% of all sarcomas. Paratesticular liposarcoma (PLS) is a rare condition. To the best of our knowledge, about 200 cases of PLS have been reported to date (1). Giant PLS is more rare with only a few cases having been reported (2-6). Due to the rarity of the disease, there is no standardized guideline as regards its incidence, diagnosis, recurrence and treatment (7,8). In this study, we present a case of a giant dedifferentiated PLS of the right testis with magnetic resonance imaging (MRI) measuring 7.8x5.8x10.4 cm and focus on the discussion about the clinical characteristics, diagnosis and treatment of this disease. Due to the giant size of this PLS, we report this case for the characteristics, diagnosis and treatment of the similar cases. The study was supported by the Ethics Committee of Peking University Shenzhen Hospital (Shenzhen, China) and written informed consent was obtained from the patient for the publication of the case details. Case reportIn July 2017, a 51-year-old man, with a complaint of swelling of the right scrotum for 2 months, was admitted to the Department of Urology of our hospital. He presented with a painless and slow-growing fixed mass in the right scrotum without conspicuous promoting or alleviating factors. There are no other signs or symptoms. A rigid mass in the right scrotum, about 8 cm in maximum diameter, was the only positive finding of physical examinations. There are no specific abnormalities in the laboratory and imaging examinations (hemogram, urinalysis, stool routine, ESR, β-human chorionic gonadotropin, a-fetoprotein, mycobacterium tuberculosis antibody Ig-G, liver and kidney function tests and chest X-ray). However, magnetic resonance ...

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“…Dedifferentiation in LPS is defined as 'nonlipogenic' tumor area occupying at least one low power (10x) in proximity of well-differentiated LPS (WDLS). 52 A wide spectrum of histological diverse components can be identified in the dedifferentiated LPS which pose considerable diagnostic challenge even in excised specimens. The initial smaller or incisional biopsy may be not be representative and may contain either differentiated liposarcomatous component or dedifferentiated component alone.…”

Section: Liposarcomamentioning

confidence: 99%

“…Four major types of dedifferentiation can be encountered in LPS. 52 In smaller biopsy tumor may be misdiagnosed according to dedifferentiated components such as rhabdomyosarcoma, follicular dendritic cell sarcoma, GIST or sometimes diagnosis may completely missed due to lack of representation. Immunohistochemistry can be of use for correct diagnosis of dedifferentiation in LPS, however, interpretation has to be made with caution.…”

Section: Liposarcomamentioning

confidence: 99%

Tumor dedifferentiation: diagnostic and therapeutic implications

Jha

2017

J Pathol Nep

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Some of the neoplasm especially malignant tumors are notorious in masquerading their cell of origin because of additional mutations which drives them to differentiate into unusual phenotype. This is implicated to a phenomenon of tumor dedifferentiation which can mislead into inappropriate categorization and therapy. Dedifferentiation is well recognized in sarcomas such as liposarcoma, chondrosarcoma and MPNST. However, it can also develop in carcinomas, melanomas and lymphomas at initial diagnosis, following therapy or at recurrence. The phenomenon has been reported in both primary tumors as well as at metastatic foci. A correct and early pathological identification of this phenomenon might profoundly help in guiding appropriate therapy. Clinical and radiological findings, immunohistochemistry and genetic analysis are often required for correct lineage identification of these tumors.

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Critical histopathological analysis of 25 dedifferentiated liposarcomas, including uncommon variants, reviewed at a Tertiary Cancer Referral Center

Cited by 20 publications

References 0 publications

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

Giant paratesticular liposarcoma: A case report and review of the literature

Tumor dedifferentiation: diagnostic and therapeutic implications

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