Primary Liposarcoma of the Stomach Resected Endoscopically

Yamamoto, Keiji; Teramae, Naoki; Uehira, Hiroshi; Wakabayashi, Naoki; Fukuda, Shinichiro; Kodama, Tatsuhiko; Kashima, Ken; Tsuchihashi, Yoshiko

doi:10.1055/s-2007-1005798

Cited by 8 publications

(6 citation statements)

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“…Lesion echogenicity is also worth mentioning. Unlike the hyperechogenic EUS feature of other pathologic types[ 10 , 24 , 25 ], our case showed isoechoic EUS features, which appeared to be related to a sparsity of immature lipocytes or lipoblasts as the WDL area was extremely limited in our patient. DL seems to have a better prognosis than other high-grade sarcomas, especially in terms of its metastatic potential.…”

Section: Discussioncontrasting

confidence: 75%

Primary gastric dedifferentiated liposarcoma resected endoscopically: A case report

Cho¹,

Byeon²,

Lee³

2022

WJG

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BACKGROUND Liposarcoma 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 SUMMARY A 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. CONCLUSION This 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.

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Section: Discussioncontrasting

confidence: 75%

Primary gastric dedifferentiated liposarcoma resected endoscopically: A case report

Cho¹,

Byeon²,

Lee³

2022

WJG

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“…Only 43 cases have been reported in the English literature, including 40 patients who received radical surgery (standard gastrectomy). The type of surgery was not described in two patients, and only one treated with endoscopic submucosal dissection (ESD) achieved free surgical margins (22,23). The surgical technique that we present allowed us to completely resect the tumor preserving the gastric parenchyma and achieving free surgical margins with greater safety than endoscopic procedures.…”

Section: Discussionmentioning

confidence: 96%

Laparoscopy-assisted trans gastric wedge resection: A safe treatment for gastric pyloric liposarcoma: a case report and literature review

Paredes¹,

Eom²,

Park³

et al. 2022

Preprint

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Background Gastric liposarcoma (GL) is extremely rare and radical surgery has been the conventional treatment, even in small tumors. Laparoscopic wedge resection has been reported worldwide forsubepithelial tumors of the stomach. Case Presentation The patient was an asymptomatic 63-year-old man presenting with a subepithelial gastric tumor. The esophagogastroduodenoscopy showed a 3 cm ulcerated soft tumor located in the posterior wall of the antrum just above the pylorus. Two preoperative biopsies were performed with a negative result for malignant neoplasm. Dynamic computerized tomography revealed 35x35mm well-defined pyloric mass with fat density. Despite the difficult location of the tumor, parenchyma-sparing surgery was performed. Surgery was initiated by a laparoscopic approach with four trocars. After the dissection of the greater omentum, the greater curvature and the posterior wall of the stomach were exposed. A gastrostomy was performed in the anterior wall of the antrum. Due to the difficulty in identifying the tumor location, a mini-laparotomy was conducted. After assessing the pylorus and section parameters, the tumor was extracted by gastrostomy and resected with a linear stapler. The patient was discharged after five days with no complications. The histological diagnosis was a well-differentiated liposarcoma. Resection margins were clear. The tumor cells tested negative for MDM2. No adjuvant therapy was indicated. The patient is alive without recurrence. Conclusions Despite its rarity, gastric liposarcoma should be respected for differential diagnosis. Minimally invasive wedge resection might be a suitable treatment even if the location is close to the pylorus.

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“…Endoscopic ultrasonography (EUS) was used by Yamamoto et al to diagnose liposarcoma. 7 However, it remains difficult to differentiate between benign and malignant tumors by EUS alone, particularly when the tumor is small. CT is considered as the gold-standard technique for establishing a definite diagnosis.…”

Section: Case Reportmentioning

confidence: 99%

“…4,16,17 A case of liposarcoma of stomach was first reported by Yamamoto et al, in which endoscopic resection was performed and no signs of recurrence were identified at 1 year after the surgery. 7 Among patients undergoing an incomplete excision, radiation therapy may double remission duration and possibly result in a clinical cure. However, radiation therapy has been found to exhibit no advantage in patients undergoing a complete resection.…”

Section: Case Reportmentioning

confidence: 99%

“…4 Liposarcoma most commonly occurs in the extremities, trunk and retroperitoneum which is extremely rare in stomach or pancreas; only a small number of cases have been previously reported around the world. [1][2][3][4][5][6][7] In the current study, a case of synchronous sclerosing liposarcoma involving pancreas and stomach in a 55 year-old female is presented. To the best of our knowledge, this is the first case of synchronous liposarcoma in these locations.…”

Section: Introductionmentioning

confidence: 99%

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Synchronous liposarcoma of pancreas and stomach: a case report and literature review

Jiang

Ying

2017

Int Surg J

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Liposarcoma is a common soft tissue sarcoma. However, its occurrence in pancreas or stomach is extremely rare. In the present study, a rare case of a 55-year-old female with sclerosing liposarcoma in pancreas and stomach is presented. Ultrasound, magnetic resonance imaging and computed tomography examinations were performed, which revealed a pancreatic mass. Subsequently, the patient underwent surgical resection of the tail of the pancreas and spleen and partial resection of stomach following the identification of a second mass. After surgery, the patient received no adjuvant treatment. Subsequent to 3 years of clinical follow up, the patient remains alive without recurrence or distant metastasis so far. As far as we know, this is the first reported case of sclerosing liposarcoma involving pancreas and stomach.

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Primary Liposarcoma of the Stomach Resected Endoscopically

Cited by 8 publications

References 0 publications

Primary gastric dedifferentiated liposarcoma resected endoscopically: A case report

Primary gastric dedifferentiated liposarcoma resected endoscopically: A case report

Laparoscopy-assisted trans gastric wedge resection: A safe treatment for gastric pyloric liposarcoma: a case report and literature review

Synchronous liposarcoma of pancreas and stomach: a case report and literature review

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