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A case of spermatic cord liposarcoma is reported. A 66-year-old male visited our hospital with the complaint of right scrotal swelling. Laboratory and radiological examinations were unremarkable. A right high orchiectomy with en bloc resection of pericordal tissue was performed. Histological examination revealed well-differentiated liposarcoma of spermatic cord. There are 19 cases of spermatic cord liposarcoma reported in Japan.
Twenty-nine cases of liposarcomas were examined by CT; in 60% of them the CT finding was that of an ill defined, often large mass with content uniformly dishomogeneous and CT numbers ranging from -40 to +28 H.U. Diagnosis of liposarcoma is often possible when this finding is recognized in a mass of the thigh or retroperitoneum where these tumors frequently arise. Authors report differential diagnosis between liposarcomas and other lipomatous tumors such as angiomyolipoma of the kidney (when it is large and only attached to the kidney by an inconspicuous pedicle) and intramuscular lipomas (50% of them are located in the thigh).
Date of an examination of 60 patients with liposarcomas of the retroperitoneal space aged from 40 to 60 are presented, women comprised 62%, men 38%. Operative treatment was undertaken in 48 patients (96%), radical operation--in 82%, palliative operations--in 14%. Recurrent tumors were revealed in 33 patients (66%), metastases--in 8%. Most frequent recidivations were noted in myxoid liposarcomas. A complete removal of the recurrent tumor was made in 72% of the cases. Out of 50 patients with liposarcomas 54.2% of the patients survived 5 or more years after the operation, in the myxoid variant--72.3%, in polymorphocellular form--23.1%.
A case of mediastinal liposarcoma in a 45-year-old man is reported. The patient was admitted to the hospital complaining of rhinorrhea. A large mass was found in the right thorax by chest X-ray. At thoracotomy, a tumor measuring 11.5 X 9 X 8.5 cm located in the anterior mediastinum with an extension to the pleural cavity formed in right middle and lower lobes was found and removed from the adjacent visceral pleura. The tumor had a fibrous capsule and was multinodular in external appearance. The cut surface was yellowish and gelatinous. The histological diagnosis of myxoid liposarcoma was made according to the subclassification of liposarcoma proposed by Enzinger et al.
A liposarcoma of the stomach, comprising one-tenth of the total body weight and judged to be inoperable, was radically removed in a 15-year-old boy. Liposarcomas rarely affect the gastrointestinal tract, especially the stomach. The three previously reported cases of liposarcoma of the stomach are also reviewed.
We report a case of a 3,100 g giant liposarcoma of the spermatic cord in an 88-year-old man. The tumor had been present for 13 years. The pathological diagnosis was well-differentiated liposarcoma of sclerosing type. Twenty-two cases of spermatic cord liposarcoma found in the Japanese literature were reviewed. This case was thought to be of the largest tumor and oldest patient in the Japanese literature.
Problems of diagnosis and classification of liposarcomas and of origin of liposarcomas in preexistent lipomas are discussed at the example of a liposarcoma of the skin of the nose that has still not been found in literature.
Human embryonal liposarcoma and embryonal fat have been studied histologically, in semithin sections, and electronmicroscopically. Specific ultrastructural features of embryonal liposarcomas allowing them to distinguish from other tumours are as follows: the presence of lipid vacuoles varying in size, number and structure, small mitochondria with dense matrix, specific filamentous apparatus, basal-like material in plasma cell membrane and in the intercellular space cytoplasmic sprouts forming peculiar "pockets" and general cell architectonics. Similarities and differences in the ultrastructure of embryonal liposarcomas and embryonal fat are found.
The clinicoroentgenological data in 45 cases (20 males and 25 females, average age 50.3 years) of soft tissue liposarcomas, histologically subdivided into 28 myxoid, 12 polymorphic and 5 round-cell tumors were compared. The means case history was 3.2 years (3.8 years--for myxoid and 2.2 years for polymorphic and roundcell liposarcomas). In 95.6% of cases, tumor sites were in the musculare of the extremities, more frequently, legs. Tumors were rather large in size (average 16.5 cm). Myxoid tumors developed slowly, causing no pain. The radiograms of these tumors showed multiple tumor nodes, reduced shadow density, structural heterogeneity, distinct contours, infrequent cutaneous infiltration and secondary changes in bones. Signs of malignancy were indistinct in angiograms. Clinically and roentgenologically, round-cell liposarcomas resembled most other types of soft tissue sarcomas. Polymorphic tumors had many features in common both with myxoid and round-cell neoplasms.
In a retrospective review all cases of liposarcoma recorded in the province of Manitoba from 1944 to 1978 were studied. There were 104 patients. Follow-up was obtained in all. Sites of tumour were peripheral limb in 45 patients, limb girdle in 15, retroperitoneal area in 23 and trunk and neck in 21. Fifty-seven percent of the patients were men: the disease was most commonly found in patients aged 50 to 69 years. Initial treatment was excision in 96 patients with irradiation in 26 and chemotherapy in 6. The 5- and 10-year survival rates were 60% and 49% respectively. In those who had definitive surgery the prognosis was somewhat better, while radiotherapy had little beneficial effect. Prognosis was also related to the pathologic type; well differentiated and myxoid types had a better prognosis than round cell or pleomorphic tumours. Trunk and peripheral limb tumours were associated with higher survival rates than limb girdle or retroperitoneal neoplasms. At least 37 patients had local recurrences; distant metastases occurred in at least 26, most commonly to the lungs, bones and liver. Unusual cases consisted of a patient with a multicentric tumour involving bones, a young boy with a neck liposarcoma and a woman with a breast liposarcoma.
The authors report a case of bulky retroperitoneal liposarcoma (6 kg) in a 42-year-old woman. This observation of liposarcoma is interesting in that diagnosis was incidental during check up for recent hypertension. The diagnosis was suggested by ultrasonography, essentially computed tomography and suspected by multiple subcutaneous lipomas. Treatment was exclusively surgical with complete tumor resection including the left adrenal gland. The authors review literature data of retroperitoneal liposarcoma. Because of frequent recurrency, follow-up of tumor resection must be made by CT scanning every six months. An aggressive surgical approach including adjacent organs if necessary and total excision of local recurrencies can improve long-term prognosis. Postoperative adjuvant radio- and/or chemotherapy does not effect survival.
Liposarcomas of the scrotum are rare with 5 cases reported previously. We report a case of myxoid liposarcoma of the scrotal wall, and discuss pathological classification and treatment of genitourinary liposarcomas.
Aspiration cytology has become an accepted procedure in the evaluation of breast abnormalities. Encountering unusual findings in cytologic material, therefore, may become more frequent. We describe a primary liposarcoma of the breast diagnosed by fine needle aspiration cytology and review the cytologic features of liposarcoma in general. The differential diagnosis is considered, and the previous literature regarding liposarcomas of the breast is reviewed.
A 76-year-old woman with a growing tumor of the anterior chest wall was admitted to our hospital. This patient was diagnosed as having the malignant pleomorphic tumor using the needle biopsy and operated on. The operative procedure included wide resection of the tumor, associated excision of the major and minor pectoris muscle. The tumor size measured 10.5 x 5.8 x 5.5 cm and weighed 580 g. Histopathologically the tumor was confirmed to be poorly differentiated liposarcoma. While there was no invasion to the surrounding tissue, the local recurrence and metastasis wasn't confirmed for the past 7 months after the surgery. The major anatomic distribution of liposarcomas were retroperitoneum and lower extremities, and liposarcomas originating from the chest wall having been reported are only 7 cases of in Japan.
Liposarcomas (LS) are malignant mesenchymal tumours which develop in fatty tissues. They are basically found at the retroperitoneum where they are relatively frequent in adults. The most common type is myxoid LS which, although less malignant, has like any other LS a high incidence of local relapses. Primary myxoid liposarcoma of the spermatic cord is an unusual, low-aggressiveness tumour. Under natural development, it can reach large dimensions with only local symptomatology. Pre-operative diagnosis of the paratesticular tumour is often difficult to establish, cuenca the teste suénate be differentiated from the tumoral mass by physical examination. A diagnostic approach of paratesticular tumours, scarcely reported in the literature, can be made by means of a vascular study with radionuclides. The choice therapy is surgical, through orchiectomy and extensive local removal. Considering the frequency of local relapse of myxoid liposarcoma, long-term follow-up is recommended. This paper reports the unusual presentation of one case of primary myxoid LS of the spermatic cord with an intrascrotal mass of 38 x 24 cm weighing 4,950 gr which is exceptional not only because of the site's infrequency but also for its size.
Abdominal liposarcomas are a rare group of tumors and their principles of treatment are based in accumulated experiences of retrospective series. PURPOSE--To report seven cases of abdominal liposarcomas and to discuss the main diagnostic and therapeutic aspects of these tumors nowadays. METHODS--Seven patients operated for abdominal liposarcomas were in the Surgical Gastroenterology Discipline of Escola Paulista de Medicina (UFESP) during 30 months. The major clinic, ultrasonographic, tomographic, surgical and histopathological features were collected in each case. RESULTS--Authors call attention to the unusualness of these tumors, their propensity (while primary) to grow in their own place, without invading the tissues around or metastasizing, and when they are recurrent to their more aggressive malignity. They consider that computerized tomography is the most useful diagnostic procedure and they discard the need of percutaneous biopsy (guided or not) in the preoperative period. They emphasize the fundamental role of radical excision surgery in these tumors treatment and also emphasize the importance of the resection with proper margins, even if an associated resection of visceral organs is necessary. They consider that now radiotherapy and chemotherapy are not very effective methods to the adjuvant treatment of these tumors. CONCLUSION--It is important an accurate follow-up of the operated patients in order to indicate, when necessary, repetitive resection surgeries, even if they are palliative (citoredution surgeries), with the purpose of improving the expectation of life.
An 11-year-old spayed female mixed-breed dog was referred for evaluation of a mass on the right forelimb of 4 months' duration. Cytologic examination of a fine-needle aspirate of the mass resulted in a diagnosis of liposarcoma. The 3 x 3 x 1.5-cm firm mass was surgically removed. Histopathologic observations confirmed the diagnosis of liposarcoma. During processing, a 1 x 0.8-cm piece of glass was found within the mass. Association between a glass foreign body and liposarcoma is discussed.
We encountered and reported one such rare case of liposarcoma which originated in the chest wall. A 60-year-old man came to our hospital with the chief complaint of a phyma in the right anterior chest wall. On palpation, a hard and non-mobile phyma measuring 3 x 3 cm was felt in the chest wall. Chest CT showed a phyma measuring 2.2 x 1.5 cm in the right anterior chest. The periphery of the phyma was smooth, and had a well-defined boundary with the surrounding tissues. Ultrasonic examination revealed that the tumor existed between the major and minor pectoral muscles. The inside of the tumor was nearly uniform, and showed low echo. Punctured cytological examination revealed scattered atypical cells with spindle, foamy or vacuolar sporophores on the mucoid matrix. A fat staining examination revealed lipoblasts with oil red-positive granules. Based on these findings, the patient was diagnosed as having myxoid type liposarcoma. Operation consisted of resection of the skin, subcutaneous tissues, mammary gland, part of major and minor pectoral muscles, the fourth and fifth ribs and pleura. The Reconstruction of the chest wall was performed for defects in the ribs and pleura using Marlex Mesh. Histopathological findings revealed that the tumor was myxoid type liposarcoma.