Dedifferentiated liposarcoma primary to the chest wall with spontaneous shrinking: report of a case

Abstract

An 80-year-old man presented to our emergency department complaining of a mass on the right side of his chest and pain in the right flank of his back. A chest computed tomography (CT) scan showed a relatively heterogenous oval-shaped tumor measuring 7.5 × 6.0 cm eroded to the 8th rib, with slightly dense fluid accumulation inside and calcification of the tumor wall. A 1-month follow-up CT scan showed spontaneous shrinkage of the tumor. The tumor was completely excised from the thoracic wall and the wall was reconstructed with a polytetrafluoroethylene mesh. Pathological examination showed coagulation necrosis in the chest wall tumor, but immunohistochemical staining revealed murine double minute 2- and Cyclin-dependent kinase 4-positive cells with irregular nuclear size and bizarre morphology. Therefore, dedifferentiated liposarcoma (DDLPS) was the final pathological diagnosis. Remarkable infiltration of CD8+ lymphocytes into the tumor was observed, along with a 90% positive ratio for programmed cell death-ligand 1. The patient has been followed-up for 1 year without any recurrence, despite not receiving any additional treatment. Liposarcoma is one of the most common types of soft tissue sarcomas; however, spontaneous regression of primary DDLPS arising from the chest wall is extremely rare. Herein, we report a case of DDLPS primary to the chest wall with spontaneous regression, probably due to a spontaneously induced T cell response.

Management of Liposarcoma With Posterior Intercostal Artery Propeller Flap Reconstruction: A Case Report

“…A contrast-enhanced CT (CECT) scan confirmed the lesion in the anterior abdominal wall. Histopathological examination of the biopsy confirmed the diagnosis of liposarcoma, specifically a dedifferentiated subtype similar to the 80-year-old patient's tumour [ 9 ]. The 80-year-old patient underwent total surgical excision of the chest wall tumour repaired with a polytetrafluoroethylene mesh [ 9 ].…”

“…Histopathological examination of the biopsy confirmed the diagnosis of liposarcoma, specifically a dedifferentiated subtype similar to the 80-year-old patient's tumour [ 9 ]. The 80-year-old patient underwent total surgical excision of the chest wall tumour repaired with a polytetrafluoroethylene mesh [ 9 ]. His resected tumour showed biomorphic features with necrotic foci and high murine double minute 2 (MDM2) and CDK4 expression, confirming dedifferentiated liposarcoma (DDLPS).…”

“…The case of the 80-year-old man reported by Itagaki et al and our case of a 57-year-old male with a swelling in the right flank share similarities and differences, particularly in their presentation, diagnostic findings, and treatment approach [ 9 ]. Both cases involve liposarcomas, although they are located in different anatomical regions.…”

“…Both cases involve liposarcomas, although they are located in different anatomical regions. The 80-year-old patient displayed a mass on the right side of his chest and related flank pain, alongside gastrointestinal side effects that had gone before the primary visit [ 9 ]. His therapeutic history included critical comorbidities such as hypertension, dyslipidemia, combined pulmonary fibrosis and emphysema, and a past cerebral infarction.…”

“…His therapeutic history included critical comorbidities such as hypertension, dyslipidemia, combined pulmonary fibrosis and emphysema, and a past cerebral infarction. An overwhelming ex-smoker with a 45-pack-year history, his chest CT scan uncovered a huge, low-density, heterogeneous tumour disintegrating the eighth rib and containing marginally dense fluid and calcifications, proposing a complex injury [ 9 ]. Despite a needle biopsy demonstrating conceivable sarcoma, a conclusive pathological diagnosis was at first slippery.…”