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

Autor: Ciongariu AM; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania., Dumitru AV; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania., Cîrstoiu C; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Orthopedic Surgery and Traumatology Department, University Emergency Hospital, 050098 Bucharest, Romania., Crețu B; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Orthopedic Surgery and Traumatology Department, University Emergency Hospital, 050098 Bucharest, Romania., Sajin M; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania., Țăpoi DA; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania., Ciobănoiu AD; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania., Bejenariu A; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania., Marin A; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Plastic Surgery Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania., Costache M; Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania.; Morphology Department, Faculty of Medicine 'Carol Davila', University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Jazyk: angličtina
Zdroj: Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2023 May 17; Vol. 59 (5). Date of Electronic Publication: 2023 May 17.
DOI: 10.3390/medicina59050967
Abstrakt: 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.
Databáze: MEDLINE
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