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At least 145 records · Page 8Linked to original sources

Liposarcoma of the neck: a clinicopathologic study of 4 cases.

A clinicopathological study of 4 patients with liposarcoma in the neck treated surgically is presented. Three of the liposarcomas were located in the supraclavicular region, two to the right one to the left, and one appeared to the left in the back of the neck. Liposarcoma rarely involves the head and neck region. A survey is given of the few reported liposarcomas in this region. Two of the tumors in the present series were well differentiated, one of which recurred repeatedly. The other two tumors were round-cell and pleomorphic in type, both of which recurred. At the end of follow-up 11 and 9 years, the two patients with well-differentiated liposarcomas were alive. The other two patients had died after 5 and 4 years from intercurrent disease and metastatic spread, respectively. The histopathological basis for the diagnosis, distinguishing features of intramuscular (infiltrating) lipoma, hibernoma and spindle cell lipoma, as well as the treatment, are discussed.

Adult↗

Cytologic features of round cell liposarcoma: a report on five patients.

BACKGROUND: Round cell liposarcoma (RCL) and myxoid liposarcoma are now considered as a single pathologic entity for several reasons. Despite many similarities, both morphologic phenotypes may differ considerably, and RCL may be difficult to recognize as liposarcoma. In addition, few cytologic reports describing features of RCL are available. METHODS: Five patients with RCL for whom cytologic study of the tumor was available were reviewed. Only tumors in which round cell or poorly differentiated, hypercellular areas comprised > 75% of the tumor were considered RCL. RESULTS: Smears were hypercellular and consisted of single, round cells with scarce cytoplasm and naked nuclei. Some cells showed slightly oval rather than round nuclei. In three tumors, the background was vacuolated; and, in two tumors, intracytoplasmic vacuoles were present. Isolated fragments of myxoid stroma containing neoplastic cells were identified in two tumors. Pleomorphism was not a prominent finding. CONCLUSIONS: RCL may show morphologic features that are uncommon for a conventional liposarcoma, leading to an erroneous cytologic interpretation. This variant of liposarcoma must be considered when evaluating round cell neoplasms, mainly in adult patients. The presence of oval cells, vacuoles (intracytoplasmic or extracellular), and myxoid stroma should raise this diagnostic possibility, avoiding confusion with other well-known round cell neoplasms.

Adult↗

Metastatic patterns of extremity myxoid liposarcoma and their outcome.

BACKGROUND AND OBJECTIVES: Extremity myxoid liposarcomas have a unique extrapulmonary metastatic potential. We studied the metastatic pattern of extremity liposarcomas to determine what types of posttreatment imaging may be of value in the follow-up these patients. METHODS: Twenty-two patients from a total of 128 patients with primary extremity liposarcoma were treated at a tertiary care institution for subsequent metastases from January 1981 to January 2000. Median follow-up was 45 months (range: 6-270 months). Data on these patients was prospectively collected and then retrospectively analyzed for effect of metastatic pattern and treatment on outcome. RESULTS: Of these 22 patients, extrapulmonary metastases developed in 10, combined pulmonary and extrapulmonary metastases developed in 6, and isolated pulmonary metastases developed in 6. Of the 16 patients with extrapulmonary metastases, 13 were of the myxoid subtype. Of the 49 patients with extremity myxoid liposarcomas, metastases developed in 14 (29%). The most common sites of metastases among these 14 patients include: the retroperitoneum, 10 patients (71)%; intra-abdominal extra-hepatic, 7 patients (50%); spinal/paraspinal, 6 patients (43%). Only 3 of the patients are alive and disease free and all 3 of these patients are from the subgroup of 10 patients with only extra-pulmonary metastases (2 intra-abdominal and 1 retroperitoneal). CONCLUSIONS: Extremity myxoid liposarcomas have an unusually high predilection for extra-pulmonary metastases, frequently without any pulmonary metastases. After treatment of the primary tumor, these patients should be followed with periodic chest X-ray and abdominal/pelvic computed tomography (CT) scans. Any back or neurologic complaints should prompt additional imaging of the appropriate spinal area. Consideration should be given to surgical and adjuvant treatment of metastatic disease when appropriate.

Abdominal Neoplasms↗

Six recent liposarcomas including largest to date.

This report describes six cases of liposarcoma. The primary sites were the retroperitoneum in three cases, the lower extremity in two cases and the jejunal mesenterium in one case. One retroperitoneum case had the heaviest liposarcoma (40 kg) that has been reported in the literature. One patient with thigh liposarcoma who developed three recurrences and underwent hemipelvectomy has been free from the disease for the past 6 1/2 years. Histologically, all three retroperitoneum cases showed well-differentiated liposarcoma and two lower extremity cases had myxoid type liposarcoma.

Adult↗

Pleomorphic liposarcoma of a young woman following radiotherapy for epithelioid sarcoma.

A case of a metachronous epithelioid sarcoma and pleomorphic liposarcoma in a young woman is described. The first tumor was an epithelioid sarcoma (ES) with focal rhabdoid features localised in the left calf while the second lesion developed seven years later in the same region was diagnosed as pleomorphic liposarcoma resembling myxofibrosarcoma ( myxoid variant of malignant fibrous histiocytoma ) predominantly composed of moderately differentiated spindle cells. Multiple foci of uni- and plurivacuolated lipoblasts were seen. Following the resection of ES the patient received 57 Gy radiation to the region, therefore we regarded the second tumor as a radiation induced liposarcoma. A further interesting feature of this case is that the development of pleomorphic liposarcoma preceded by 6 months the solitary right parabronchial metastasis of ES and after 4 months of metastasectomy a third tumor developed at the site of the first lesion. This tumor showed dedifferentiation toward pleomorphic malignant fibrous histiocytoma. Our case represents a unique case of postirradiation liposarcoma developed on the base of ES.

Adolescent↗

[Liposarcoma of the extremities: recent developments in surgical therapy--analysis of 167 patients].

Liposarcoma is the second most common malignant soft-tissue tumor in adults. Between 1991 and 2002, 167 patients with extremity liposarcomas were treated in our center. Fifty tumors were classified as G1 liposarcomas (30%), 76 as G2 liposarcomas (45.5%), and 41 as G3 liposarcomas (24.5%). In 158 patients, (93.5%) wide tumor excision was performed. Major amputation was necessary in five patients. After a median follow-up of 36 months, 37 patients had developed local recurrence. The 5-year overall survival rate was 79%. The 5-year survival rate in primary tumors was 71/79 (90%, P<0.05) whereas 61/88 of recurrences relapsed locally (69%, P<0.05). Multidisciplinary cooperation in a tumor board is a precondition for adequate treatment.

Adult↗

Predictive value of gadolinium enhancement in differentiating ALT/WD liposarcomas from benign fatty tumors.

OBJECTIVE: To determine the predictive value of gadolinium enhancement on MRI in differentiating atypical lipomatous tumor (ALT)/well-differentiated (WD) liposarcoma from benign fatty tumors. DESIGN: All histologically proven fatty tumors with preoperative gadolinium-enhanced MRI were reviewed. Only those tumors with predominantly fatty signal were included. Sensitivity, specificity, and positive and negative predictive values for both gadolinium enhancement and biopsy as predictors for the final diagnosis of ALT/WD liposarcoma were calculated. PATIENTS: From 129 patients evaluated for fatty tumors between 1994 and 2002, the patient population was narrowed to 32 excised fatty tumors with preoperative gadolinium-enhanced MRI. RESULTS: As a predictor of ALT/WD liposarcoma, the presence of gadolinium enhancement showed 100% sensitivity, 71% specificity, 53% positive predictive value and 100% negative predictive value. Needle or incisional biopsy yielded 57% sensitivity, 100% specificity, 100% positive predictive value and 63% negative predictive value for a diagnosis of ALT/WD liposarcoma. CONCLUSIONS: Gadolinium enhancement of a homogeneous fatty soft tissue tumor is a sensitive screening tool to determine possible diagnosis of ALT/WD liposarcoma. Biopsy, on the other hand, is specific but insensitive.

Adult↗

Primary pleomorphic liposarcoma of bone: MRI findings and review of the literature.

Primary liposarcoma of bone is exceedingly rare. We report a case of primary pleomorphic liposarcoma in the humerus of a 38-year-old female. Radiographs demonstrated an expansile and osteolytic lesion extending from the head to the proximal part of the shaft in the right humerus. MR study showed a defined lesion in the humerus. The lesion had an iso-signal intensity and partial high-intensity lesion on T1-weighted images and a heterogeneous high signal intensity on T2-weighted images. Wide resection and proximal humeral endoprosthesis replacement were performed. Final pathological diagnosis of the lesion was pleomorphic liposarcoma. This is the second reported case of pleomorphic liposarcoma of the bone, and the first case presenting MRI findings for liposarcoma of bone.

Adult↗

Liposarcoma subtypes: identification with computed tomography and ultrasound-guided percutaneous needle biopsy.

The purpose of the study was to evaluate the feasibility of image-guided percutaneous needle biopsy to enable specific subtype classification of liposarcoma in patients with previously diagnosed disease and compare the yield of fine and large needle techniques for each subtype. We reviewed the medical records and pathology reports of 69 fine (20 g) needle and large (15, 16 g) needle biopsies performed in 44 patients enrolled in a clinical trial evaluating the effect of a novel therapy for advanced liposarcoma in the abdomen and pelvis. Cytopathologists and surgical pathologists identified features that enabled them to classify the tumor into one of four subtypes: well differentiated, myxoid/round cell, pleomorphic and dedifferentiated. The pre-study open surgical biopsy was used as the standard for comparison. The diagnostic yield (proportion of biopsies with correct subtype diagnosis) of percutaneous biopsy for identifying all subtypes of liposarcoma was 81% (64% for fine needles and 73% for large needles alone). There was a significant association between pathologic subtype and the probability of a correct diagnosis (P=0.05). Accurate diagnostic subset classification of liposarcoma by percutaneous biopsy is feasible, although both fine and large needles should be used. Although these data cannot be extrapolated to primary diagnosis of liposarcoma, they are important for screening and subtyping of possible recurrence.

Adult↗

The association between tumour progression and vascularity in myxofibrosarcoma and myxoid/round cell liposarcoma.

Angiogenesis is an important factor in the morphological progression and metastasis of many solid tumours. We studied two homogeneous series of myxofibrosarcoma (MFS) and myxoid/round liposarcoma (MRLS), characterised by distinct vascular patterns and correlated the intratumoral microvessel density (IMD) with morphologic progression in both types of sarcoma. In our study, 43 cases of MFS and 42 cases of MRLS were graded according to established diagnostic criteria. For evaluation of IMD, representative sections were stained immunohistochemically for CD31. After selection of "neovascular hot spots", IMD was calculated by measuring the endothelial surface within twenty 200x fields in relation to the total analysed area. In addition to the correlation of IMD with histological grades of malignancy, a correlation of IMD with the inflammatory infiltrate in MFS was done. To determine whether vascular endothelial growth factor (VEGF) and its receptors, KDR and flt-1, may play a role in the progression of both types of sarcomas, we used mRNA in situ hybridisation (ISH) to study VEGF, KDR and flt-1 expression in selected cases. In addition, the expression of thrombospondin-1, which has been reported to inhibit angiogenesis, and of collagen type I was studied using mRNA ISH. Cases of MFS varied histologically from hypocellular, mainly myxoid, neoplasms (low-grade malignant, 18 cases) to intermediate-grade malignant lesions with increased cellularity and mitotic activity (13 cases), and high-grade malignant cases with marked pleomorphism, high proliferative activity and areas of necrosis in many cases (12 cases). Cases of purely low-grade myxoid liposarcoma (16 cases) were characterised by low-cellularity, mucin pooling and plexiform vasculature. In combined MRLS, these hypocellular areas were admixed with hypercellular, round cell areas (5-80% of the analysed tumour area; 23 cases), and in round cell liposarcoma (three cases) rounded tumour cells predominated (>80% of the analysed tumour area). The average IMD in intermediate and high-grade malignant MFS (4.03 and 4.09, respectively) was significantly higher than in low-grade malignant MFS (2.73). Correlation of vascularity with the inflammatory infiltrate in MFS showed increased IMD only in cases with abundant neutrophils; most of these cases were high-grade malignant neoplasms. In contrast, no statistical correlation between morphological progression and IMD was seen in myxoid liposarcoma (6.08), MRLS (6.57) and round cell liposarcoma (4.07). VEGF mRNA was expressed by tumour cells in all histological grades of MFS and MRLS. VEGF receptor mRNA was weakly expressed by endothelia of newly formed blood vessels in both entities. Interestingly, tumour cells of all analysed cases of MFS strongly expressed collagen type I and thrombospondin-1, while these proteins were not detected in tumour cells of MRLS. In conclusion, morphologic tumour progression in MFS is associated with increased IMD, whereas, in MRLS, no such correlation is seen. Whereas VEGF and VEGF receptor mRNA were expressed in both entities, a characteristic expression profile of collagen type I and thrombospondin-1 in MFS emerged. Further studies are necessary to correlate vascularity and clinical course in MFS and MRLS.

Adolescent↗

Liposarcoma of the oropharyngeal region. Review of the literature and report of two cases.

Liposarcomas of the oropharyngeal regions are exceedingly rare. Their silent, slow growth, submucosal or deep location, circumscription, and firm but resilient texture often suggest a diagnosis of a cyst or benign soft-tissue neoplasm. Two cases of well-differentiated myxoid liposarcoma are presented. The literature of over half a century was reviewed, and all documented cases were critically analyzed. The clinical data correlated with the histopathology and biologic behavior of the tumors indicated that two thirds of all liposarcomas of the head and neck are of the myxoid type. The well-differentiated myxoid liposarcoma was the most common one and has an over-all favorable prognosis. Lipomas of the oropharyngeal regions are relatively common and small, generally not exceeding 2.5 cm. in greatest diamter. A lobulated firm tumor of fast tissue significantly exceeding this size should be strongly suspected of being a liposarcoma.

Adult↗

Chromosome abnormalities in liposarcomas.

We performed a cytogenetic study of short-term cultures from fresh surgical specimens obtained from four patients with liposarcoma. Myxoid liposarcomas (cases 1-3) were associated with a specific translocation between chromosomes 12 and 16. Trisomy 8, a nonrandom secondary aberration in myxoid liposarcoma, was observed in the third case as the only additional change. Round cell liposarcoma (case 4) showed complex chromosomal aberrations affecting chromosomes 1, 2, 5, 6, 7, 13, 14, 17, 19, and 22. Neither band 12q13 nor 16p11 was visibly rearranged. Three subgroups of liposarcomas are proposed. The first group is characterized by t(12;16)(q13;p11), the second group by ring chromosomes, telomeric associations, and giant markers, and the last by complex numerical and structural aberrations.

Adult↗

Primary pleomorphic liposarcoma of the parotid gland: a case report and review of the literature.

Although liposarcomas are the most common type of sarcoma in adults, they are rare in the head and neck region. Pleomorphic liposarcoma is the least common histologic subtype in all locations. To our knowledge, there have been only 11 reported cases of primary liposarcomas of the major salivary glands, and the pleomorphic variant arising in the parotid gland has been reported only once before. Only 2 of the 11 reported cases of liposarcoma of the major salivary glands in the literature have died of disease, and both cases were of the pleomorphic subtype. We report a case of pleomorphic liposarcoma arising in the left parotid gland of an 80-year-old woman. This case report highlights that, despite conservative surgery followed by 2 local recurrences, our patient is doing well with minimal local morbidity and no demonstrable metastases 30 months after the initial diagnosis. We also present a review of the literature on the subject.

Aged↗

Cytogenetic and molecular genetic findings in dedifferentiated liposarcoma with neural-like whorling pattern and metaplastic bone formation.

Dedifferentiated liposarcoma, a subtype of liposarcoma, is characterized by juxtaposition of well-differentiated liposarcoma with a nonadipocytic sarcoma. A peculiar form of dedifferentiated liposarcoma has been described, characterized by a nonlipogenic component with a neural-like whorling pattern of growth and metaplastic bone formation. We report the cytogenetic and molecular genetic findings of this peculiar form of dedifferentiation in a retroperitoneal tumor found in a 58-year-old woman. The neoplasm had the typical histologic findings and a complex karyotype characterized by several numeric and structural chromosome abnormalities, including the presence of ring and giant rod chromosomes. Molecular genetic studies found high levels of amplification of the MDM2 oncogene, consistent with the amplification of the 12q14 chromosome band, a cytogenetic abnormality commonly found in these tumors. These findings indicate that, despite its unique and peculiar morphologic features, this unusual type of dedifferentiated liposarcoma shares many of the cytogenetic and molecular genetic abnormalities found in other forms of dedifferentiation. However, the specific cytogenetic and molecular determinants of these peculiar morphologic findings remain unknown.

Bone and Bones↗

Cytogenetic and molecular cytogenetic findings in dedifferentiated liposarcoma with neural-like whorling pattern and metaplastic bone formation.

Dedifferentiated liposarcoma is a subtype of liposarcoma characterized by juxtaposition of well-differentiated liposarcoma with a nonadipocytic sarcoma. A peculiar form of dedifferentiated liposarcoma has been described, characterized by a nonlipogenic component with a neural-like whorling pattern of growth and metaplastic bone formation. We report the cytogenetic and molecular genetic findings of this peculiar form of dedifferentiation in a retroperitoneal tumor found in a 58-year-old female. The neoplasm had typical histologic findings and a complex karyotype characterized by several numeric and structural chromosomal abnormalities, including the presence of ring and giant rod chromosomes. Molecular cytogenetic studies found high levels of amplification of the MDM2 oncogene, consistent with the amplification of the 12q14 chromosome band, a cytogenetic abnormality commonly found in these tumors. These findings indicate that, despite its unique and peculiar morphologic features, this unusual type of dedifferentiated liposarcoma shares many of the cytogenetic features and molecular genetic abnormalities found in other forms of dedifferentiation. The specific cytogenetics and molecular determinants of these peculiar morphologic findings, however, remain unknown.

Bone and Bones↗

Liposarcoma of the colon: a case report and review of literature.

Liposarcoma is a malignant mesenchymal tumor frequently located in the retroperitoneum and rarely presents as an isolated lesion in the colon. To our knowledge, only three cases of primary colon liposarcoma have been reported in the world literature to date. In this article, we report a case of liposarcoma of the colon in a 46-year-old man. The patient presented with abdominal pain and a palpable mass. Abdominal ultrasonography and computed tomogram confirmed the presence of a large intra-abdominal fatty tissue mass, but the colon origin of the tumor was revealed only on laparotomy. During surgery, a voluminous (12 cm x 11 cm x 10 cm) lesion situated in the subserosa of the ascending colon was found, and a right hemicolectomy with radical lymph node dissection was performed. The pathological diagnosis of the resected tumor revealed primary colon liposarcoma (myxoid subtype). The postoperative course was uneventful, and the patient remained free of disease for 12 months. No adjuvant therapy was performed. Diagnostic and therapeutic problems related to this type of neoplasm as well as literature reviews are reported. Curative R0 resection remains the main treatment for primary and recurrent liposarcomas.

Colonic Neoplasms↗

The value of MDM2 and CDK4 amplification levels using real-time polymerase chain reaction for the differential diagnosis of liposarcomas and their histologic mimickers.

Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and dedifferentiated liposarcoma (DDL) are reported to have murine double-minute type 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) amplification as a characteristic genetic alteration. To evaluate the diagnostic utility of this gene abnormality, we analyzed 19 liposarcomas, 21 malignant fibrous histiocytomas, 3 leiomyosarcomas, 5 malignant peripheral nerve sheath tumors, 23 lipomas, and 28 nonneoplastic fat tissues using real-time polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH). In real-time PCR, all ALT/WDLs and DDLs had both MDM2 and CDK4 amplifications. The amplification levels in ALT/WDLs and DDLs were significantly higher than those in the other sarcomas, lipomas, and nonneoplastic fat tissues (P < .05); however, those in the other sarcomas and lipomas were not significantly higher than those in nonneoplastic tissues. In FISH, all ALT/WDLs and DDLs had both MDM2 and CDK4 amplifications, and all of the myxoid/round cell liposarcomas, leiomyosarcomas, malignant peripheral nerve sheath tumors, and all but one of the malignant fibrous histiocytomas did not have the amplifications. In this study, MDM2 and CDK4 amplifications were confirmed in ALT/WDLs and DDLs, and the amplification levels were significantly higher than those in the other tumors. An analysis of MDM2 and CDK4 amplification using real-time PCR, as well as FISH, is useful for the differential diagnosis of liposarcomas and their histologic mimickers.

Adipose Tissue↗

Growth inhibitory effect of quercetin on SW 872 human liposarcoma cells.

Adipocytic tumors represent the largest single group of soft tissue tumors. In the present study, we investigated the antiproliferative potential of quercetin in SW 872 human liposarcoma cells. Cell viability was significantly influenced by quercetin treatment in a time- and dose-dependent manner. Flow cytometric analyses of SW 872 human liposarcoma cells exposed to quercetin showed that the increase of apoptotic cells was time- and dose-dependent. The percentages of normal cells were decreased and apoptotic cells (including early apoptotic and late apoptotic) were increased with increasing concentrations of quercetin. Quercetin-induced apoptosis in SW 872 human liposarcoma cells was associated with the loss of mitochondrial membrane potential (DeltaPsi(m)). The apoptosis in SW 872 human liposarcoma cells induced by quercetin was mediated through the activation of caspase-3, Bax, and Bak and then cleavage of PARP and downregulation of Bcl-2. These results demonstrate that quercetin may prevent atypical lipomatous tumors/well-differentiated liposarcomas from mature adipocytic proliferation, which may contribute to its antiproliferative function.

Annexin A5↗