Primary Dedifferentiated Liposarcoma of the Axilla Arising in a Mixed, Well-differentiated and Myxoid Liposarcoma

Campbell, Garth Seamus; Lawrence, Thomas Joseph; Porter, Scott E.; Rezeanu, Luminita

doi:10.3941/jrcr.v6i1.867

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…After consulting the surgeon we came to the conclusion that the original tissue of the sarcoma was most probably the axilla ligament where the tumor had a consistent base. We found only one report about sarcoma in this localization, but the histological type was different liposarcoma (Manabe et al, 2005;Davidescu et al, 2011;Campbell et al, 2012).…”

Section: Discussionmentioning

confidence: 93%

Unusual Clinical Tumor Development in Axilla

Strunová

Pavlišta

et al. 2013

Prague Med. Rep.

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R e c e i ve d M ay 3 0 , 2 0 1 3 ; A c c e p t e d A u g u s t 1 4 , 2 0 1 3 . Key words: Axilla -Sarcoma -Neurogenic sarcomaAbstract: This work describes clinical development of a sarcoma in the left axilla of a 36-year-old woman. The macroscopic picture changed from the initial inflammatory reddening to globular resistance of 2.5 cm, suggestive of an enlarged lymph node. Mammography did not reveal any associated breast disease. Colliquation found on the ultrasound images led to a biopsy, the result of which indicated only an inflammation, without any malignancy. Rapid growth of the axillar tumor to 10 cm in size within 8 weeks prompted surgery allowing proper diagnosis of a small mature-to-immature sarcoma. Special examinations performed by a histopathologist (at the Institute for Histopathology) could not establish the precise histogenesis, i.e. the tissue origin. Therefore it was necessary to remove any clinically obscuring tumor for the final proper histological diagnosis and adequate treatment of the patient. Prague Medical Report / Vol. 114 (2013) No. 3, p. 191-196 IntroductionIn the personal anamnesis of our 36-year-old patient (G2/P2) no relation to the present ailment was found. The gynecological anamnesis showed two spontaneous child births, after the second birth a conization was performed, which had a histological finding of CIN 2. The patient used hormonal contraceptives, which was changed after the conization to IUD -Mirena. The patient's weight was 65 kg, and her height was 165 cm.At a regular gynecological check-up the patient indicated an inflammatory lesion in her left armpit, with a reddish area reminiscent of folliculitis. The patient was given local treatment, and subsequently the inflammation subsided. 3 weeks later the patient returned having found an axillar resistance which was movable with restrictions. The skin over the formation was without any pathological findings.On 23 April 2012 there a mammography was performed to establish any correlation with the breast area. The mammographic type was glandular; an ultrasonic check discovered a small cyst to the left in the top outside quadrant, while in the right breast two fibromas about 4 mm in size were found in the top outside quadrant behind the nipple areola, and in the left axilla there was a globular hypoechoic node with slight vascularization in the periphery, 28 mm in size, of an infiltrated character. After consulting the mammography center, a biopsy using an ultrasound was undertaken. Puncture samples from the resistance were processed into a block and sliced up in their entirety. Microscopic image showed ligament and adipose tissue with vessels and nerves and sparse uncharacteristic globo-cellular cellularization. No structures of lymph nodes were present, and the samples did not contain any tumor growth. The patient came for a check-up two weeks later. Owing to the negative histological result, and based on the confirmed chronic nodes in the right axilla, we performed only a supplementary examination, resulting in the decis...

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Section: Discussionmentioning

confidence: 93%

Unusual Clinical Tumor Development in Axilla

Strunová

Pavlišta

et al. 2013

Prague Med. Rep.

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“…Studies provide evidence of prominent vascular capillary networks within dedifferentiated liposarcoma with myxoid stroma and suggest both myxoid liposarcoma and myxofibrosarcoma should be taken into consideration as a differential diagnosis [ 22 , 23 , 24 ]. Apart from the differential diagnosis between myxoid liposarcoma and its dedifferentiated counterpart, there is a small focus on highly pleomorphic liposarcomas with mixed elements [ 25 ]. Campbell et al report a case of a mixed lesion of the axilla comprising well-differentiated, dedifferentiated elements adjacent to a myxoid liposarcoma component [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Apart from the differential diagnosis between myxoid liposarcoma and its dedifferentiated counterpart, there is a small focus on highly pleomorphic liposarcomas with mixed elements [ 25 ]. Campbell et al report a case of a mixed lesion of the axilla comprising well-differentiated, dedifferentiated elements adjacent to a myxoid liposarcoma component [ 25 ]. In relation to this phenomenon, we highlight the importance of immunohistochemical tests and genetic analysis as reliable methods for assessing the response to neoadjuvant therapy [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

The Conundrum of Dedifferentiation in a Liposarcoma at a Peculiar Location: A Case Report and Literature Review

Ciongariu,

Dumitru,

Cîrstoiu

et al. 2023

Medicina

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Dedifferentiated liposarcoma of the deep soft tissue of the lower extremities is an infrequent finding. Myxoid liposarcoma is considered the most common soft tissue neoplasia arising in this anatomic region. Divergent differentiation usually occurs within well-differentiated liposarcoma and is exceedingly rare in a myxoid liposarcoma. We report a 32-year-old man who developed a dedifferentiated liposarcoma of the thigh on the background of a pre-existing myxoid liposarcoma. The gross examination of the surgical specimen showed a 11/7/2 cm tumour mass with solid tan-grey areas and focal myxoid degeneration. The microscopic examination revealed a malignant lipogenic proliferation, containing round cells with hyperchromatic nuclei and atypical lipoblasts, confined to the basophilic stroma with a myxoid aspect. Abrupt transition towards a hypercellular, non-lipogenic area consisting of highly pleomorphic spindle cells with atypical mitotic figures was also noted. Immunohistochemical staining was performed. Tumour cells in the lipogenic area were intensely positive for S100 and p16, and CD34 staining highlighted an arborizing capillary network. The dedifferentiated tumour areas showed positive MDM2 and CDK4 staining within neoplastic cells, with the Ki 67 proliferation marker expressed in approximately 10% of the cells. Wild-type TP53 protein expression pattern was documented. Thus, the diagnosis of a dedifferentiated liposarcoma was established. This paper aims to provide further knowledge about liposarcomas with divergent differentiation at peculiar locations, emphasizing the importance of histopathologic examination and immunohistochemical analysis for establishing the diagnosis and assessing the therapeutic response and prognosis of this condition.

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“…1 According to the most recent World Health Organization (WHO) classification, DDLS is one of the 5 subtypes of liposarcoma 2 and it is composed of 2 distinct components: a WDLS and a nonlipogenic sarcoma. In 90% of cases the dedifferentiated component is represented by a high-grade undifferentiated pleomorphic sarcoma, while only rarely a rhabdomyosarcomatous, leiomyosarcomatous 3 or an osteosarcomatous component can be encountered.…”

Section: Discussionmentioning

confidence: 99%

Dedifferentiated Liposarcoma of Retroperitoneum With Extensive Osteosarcomatous Component

Trombatore

Caltabiano

Giovanni

et al. 2016

International Surgery

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Dedifferentiated liposarcoma (DDLS) is a rare subtype of liposarcoma composed of 2 components: a well-differentiated liposarcoma (WDLS) and a nonlipogenic sarcoma (dedifferentiation component), represented in .90% of cases by a high grade undifferentiated pleomorphic sarcoma, in the form of both small microscopic foci and/ or grossly recognizable nodular masses. The paper reports a rare case of a retroperitoneal DDLS, in which approximately half of a tumor mass is composed of a high-grade osteosarcoma. A 68-year-old Caucasian woman affected by abdominal discomfort. Clinical examination showed a large, hard and fixed abdominal mass. Computed tomography scan revealed a huge retroperitoneal mass composed of 2 distinct components: the upper part showed a hypodense tissue, while the lower part showed a higher density and coarse calcifications. Patient underwent to a challenging surgical resection of the mass that, at histological examination, resulted to be a DDLS, in which a WDLS coexisted with an osteosarcoma. Presurgical diagnosis of DDLS is difficult due to the great morphologic variability of the dedifferentiated component, ranging from low to high-grade nonlipogenic sarcoma. The present case contributes to widen the morphological spectrum of DDLS, emphasizing the possibility that a retroperitoneal mass with a

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Primary Dedifferentiated Liposarcoma of the Axilla Arising in a Mixed, Well-differentiated and Myxoid Liposarcoma

Cited by 5 publications

References 10 publications

Unusual Clinical Tumor Development in Axilla

Unusual Clinical Tumor Development in Axilla

The Conundrum of Dedifferentiation in a Liposarcoma at a Peculiar Location: A Case Report and Literature Review

Dedifferentiated Liposarcoma of Retroperitoneum With Extensive Osteosarcomatous Component

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