Rare Case of Primary Pulmonary Pleomorphic Liposarcoma Treated With Multimodal Therapy (original) (raw)
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Lung and Chest-Wall Metastasis of Liposarcoma
Lung, 2015
A 57-year-old woman was admitted to our institution with a painful mass on the right thigh. Biopsy revealed dedifferentiated liposarcoma (LS). The lesion was surgically resected, and the patient underwent 4 months of radiotherapy. 1 year later, she developed a growing mass in the posterior chest wall associated with pain and paraplegia. The mass was fixed to the left paraspinal region and measured approximately 8 cm. Chest computed tomography (CT; Fig. 1) showed a large mass with heterogeneous contrast enhancement containing low-density components, suggesting the presence of fat in the left paravertebral region and invading adjacent structures. Parenchymal lung nodules with fat density were also seen in the right inferior lobe. Magnetic resonance imaging (MRI; Fig. 2) confirmed the CT findings and demonstrated invasion of the spinal canal with cord compression and vertebral metastasis. A biopsy of the thoracic mass confirmed the diagnosis of dedifferentiated LS metastasis (Fig. 3). The patient underwent palliative chemotherapy and radiotherapy and died 4 months later from sepsis.
Primary pleomorphic liposarcoma of the spine. Case report and review of the literature
International Journal of Surgery Case Reports, 2016
INTRODUCTION: To describe a single case, the fourth ever reported, of pleomorphic liposarcoma of the spine and to undertake a review of the literature. PRESENTATION OF CASE: A 60 year old male patient had a bilateral lumbosciatica over a 3 month period. Imaging tests revealed a tumor mass in L1-L3 and a fracture in L2. Also, he had a mural thrombus both in the inferior vena cava and the left renal vein. The biopsy revealed a well-differentiated liposarcoma. En bloc resection of the lesion and stabilization was carried out. Due to the condition of the patient (hemodynamic instability, wound dehiscence and infection, and hypoproteinemia), a decision was made not to subject the patient to either radiation therapy or chemotherapy. The patient was subsequently found to suffer from myopathic paraparesis and a surgical wound infection. At three months, liver metastases were evident, as well as a recurrence of the lesion. A venous thrombosis that extended from the lower iliac vein to the right atrium was observed. The patient died from type I hepatorenal syndrome. DISCUSSION: Pleomorphic liposarcoma of the spine is a rare occurrence. En bloc resection with wide margins is the treatment of choice. The use of radiotherapy in the spine is controversial. The role that should be played by chemotherapy is still unclear, although it has been employed in treatments. CONCLUSION: In spite of treatment, these tumors lead to a poor prognosis, with high rates of recurrence, metastasis, and mortality.
Pleomorphic Liposarcoma Presenting as Extracardiac Mediastinal Mass Leading to Cardiac Compression
2021
A 45-year-old male presented with a 3-month history of fever associated with dyspnea, orthopnea, weight loss, chest pain, and anorexia. Past history was notable for cigarette smoking of 5 packs per year. Examination findings suggested clubbing, raised jugular venous pulse and pedal edema. Characteristic findings on systemic examination were displaced apex beat, sternal heave, bibasilar crepitations, distended abdomen, and presence of shifting dullness. Echocardiography revealed an extracardiac mass collapsing mostly the right side of the heart. Later, multidetector computed tomography scan (MDCT) was done which detected a mediastinal mass crossing midline, significantly compressing right sided cardiac chambers, adjacent segments of major arteries and veins, and displaced esophagus to the left. An ultrasound guided biopsy confirmed the diagnosis of pleomorphic liposarcoma. Although it turned out to be a surgical case, but the objective of reporting this case of pleomorphic liposarco...
2010
We report a case of primary recurrent mediastinal dedifferentiated liposarcoma with unusual long-term survival. A woman who complained of dyspnea showed on imaging features a bulky posterior mediastinal mass which was completely excised and initially misdiagnosed as an angiomyolipoma. She recurred 15 months later and histological examination showed a dedifferentiated liposarcoma. Resection was incomplete and the patient received adjuvant therapy. Eight years later a second recurrence occurred in the right pleura and lung. The patient died three months later. 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
Case Reports in Orthopedics, 2022
Background. Pleomorphic liposarcoma (PLPS) accounts for less than 5% of liposarcoma, and its metastasis to bone is rare. As a high-grade tumor, PLPS is reported to be more invasive with high local recurrence and distant metastasis. Here, we report a case of PLPS of the femur and undertake a review of the literature. Case Presentation. A 58-year-old man presented with a big mass at posterior aspect of his left thigh. The computed tomography of the chest for staging revealed two nodules at the left upper lung field. Wide resection of the soft tissue mass at the left thigh was performed by a general surgeon. Thoracotomy and wedge resection of the lung nodules was carried out by a cardiothoracic surgeon. Pathologic diagnosis suggested PLPS. Three years later, he was presented with sudden right hip pain after he slipped. The plain radiograph revealed an osteolytic lesion at the right proximal femur with minimally displaced pathological fracture. The MRI showed the presence of a tumor at ...
Archivos de Cardiología de México, 2019
Liposarcomas represent the second most common type of soft tissue sarcomas after malignant fibrous histiocytoma. There are four histological subtypes according to the World Health Organization: well-differentiated (atypical lipomatous) liposarcoma, dedifferentiated, myxoid (round-cell) liposarcoma (ML), and pleomorphic liposarcoma 1. Their primary anatomical sites of origin from liposarcomas are the retroperitoneum in 25-50% and the lower limbs in 25-35%. The most frequent distant sites for metastasis arising from ML include lungs, retroperitoneum, abdominal cavity, and chest wall 1. ML accounts for 30-50% of all liposarcomas, with a peak incidence between the third and the fifth decade of life, being more frequent in males than females, exhibiting an overall metastatic rate of 30%. Interestingly, it has an expansive growth pattern, with less aggressive infiltrative behavior, thus, causing frequently obstructive clinical syndromes at the main site of metastasis, however, metastatic intracardiac soft tissue sarcomas represent an extremely rare clinical
Pleomorphic liposarcoma of bone: a rare primary malignant bone tumour
Clinical Sarcoma Research, 2018
Background: Liposarcoma is an extremely rare primary bone sarcoma. Case presentation: We report a case of primary pleomorphic liposarcoma that arose in an 18 year old male in the metaphysis of the left tibia. Plain radiographs showed a partly sclerotic lesion and MR imaging a heterogeneous tumour predominantly isointense on T1-and high-signal on T2-weighted sequences with focal areas of increased T1 signal that suppressed with fat saturation. PET/CT showed marked FDG uptake (SUV = 17.1) in the primary tumour as well as a metastasis in the right distal femur and multiple small pulmonary metastases. Histologically, the tumour was a pleomorphic liposarcoma containing large tumour cells with vacuolated cytoplasm and hyperchromatic pleomorphic nuclei as well as numerous lipoblasts and scattered brown fat-like cells. Tumour cells strongly expressed FABP4/ aP2, a marker of adipocyte differentiation, and UCP1, a marker of brown fat, but not S100. The case was treated with neoadjuvant MAP chemotherapy, resulting in extensive (> 95%) necrosis in the primary tumour and almost complete resolution of the femoral and pulmonary metastases. Conclusions: Pleomorphic liposarcoma can present as a sclerotic primary malignant bone tumour; markers of adipose differentiation are useful in histological diagnosis and neoadjuvant MAP chemotherapy results in significant tumor necrosis.
International Journal of Cancer Management
Introduction: Soft tissue sarcoma (STS) is a rare tumor with mesodermal origin. There are more than 100 different types of histology in sarcoma, which present different clinical behaviors. Liposarcoma, leiomyosarcoma, and undifferentiated pleomorphic sarcoma are among the most common pathologies Case Presentation: The patient was a 46-year-old man with 2 masses. The pathology of chest-wall mass (250 × 187 mm) was compatible with undifferentiated pleomorphic sarcoma (UPS). Arm mass (42 × 29 mm) pathology was suggestive of low-grade epithelioid leiomyosarcoma with smooth muscle differentiation. He received two cycles of mesna and doxorubicin and ifosfamide (MAI) regimen chemotherapy due to large and multiple masses, but the tumor size did not change. After consultation with an orthopedic oncosurgeon, wide masses resection was done. Adjuvant chemotherapy with an MAI regimen was continued for a total of 6 courses and radiation with a 60 Gy total dose to the posterior aspect of the chest...
Primary mediastinal liposarcoma: a case report
Journal of Medical Case Reports, 2007
Introduction: Liposarcoma is the most commonly diagnosed soft tissue sarcoma in adults and occurs predominantly in the lower limbs and retroperitoneum. Primary mediastinal liposarcomas are rare.