ABSTRACT
RESUMEN El liposarcoma es un tumor maligno de origen mesodérmico derivado del tejido adiposo. Es el más frecuente de los sarcomas de partes blandas en el adulto. La localización más frecuente es en extremidades inferiores; la abdominal es rara. Llega a alcanzar enormes proporciones. El tratamiento es la cirugía con resección completa para el control local de la enfermedad. Se presenta el caso de una paciente que acudió por hallazgo ecográfico de tumor intrabdominal en hipogastrio de origen no precisado, con evolución asintomática. Al examen físico se constató proceso tumoral palpable hacia hipogastrio de aproximadamente 3cm, suave, móvil, no superficial, no doloroso a la palpación. Se realizó laparotomía exploradora electiva, con omentectomía total por tumor en borde libre del omento mayor. La biopsia informó la presencia de liposarcoma mixoide de omento mayor. Debido a la poca frecuencia de este tipo de lesión se decide presentar el caso de esta paciente.
ABSTRACT Liposarcoma is a malignant tumor of mesodermal origin derived from adiposetissue. It is the most frequent of the soft tissue sarcomas in adults. Themost frequent location is in the lower extremities, the abdominal is rare.It reaches enormous proportions. Treatment is surgery with completerresection for local control of the disease. The case of a patient whopresented due to ultrasound finding of an intra-abdominal tumor in thehypogastrium of unspecified origin, with asymptomatic evolution, ispresented. Physical examination revealed a palpable tumor process towardsthe hypogastrium of approximately 3cm, smooth, mobile, non-superficial, notpainful on palpation. Elective exploratory laparotomy was performed, withtotal omentectomy for tumor on the free edge of the greater omentum. Biopsyreported the presence of myxoidliposarcoma of the greater omentum. Due tothe infrequency of this type of injury, it was decided to present the caseof this patient.
ABSTRACT
@#Primary omental liposarcoma is a rare clinical entity with less than 20 cases being reported in the literature. Laparotomy has been the traditional approach for resection, with no reports of laparoscopic resection. A 39-year-old lady presented at the Sarawak General Hospital, Kuching, Malaysia with a history of a progressive, painless left upper quadrant abdominal swelling for a year. CT scan showed a well-defined heterogeneously enhancing cystic mass measuring 7.5x7.5x8.1cm with a poor plane with the adjacent greater curvature of stomach and transverse colon. Upper and lower endoscopy was normal. The tumour was completely dissected from the adjacent transverse colon and removed laparoscopically. Histopathological examination of the resected specimen revealed a myxoid liposarcoma. She had an uneventful recovery and was discharged well on the third postoperative day. She subsequently underwent adjuvant chemotherapy and was well at 1-year follow-up with PET CT showing no evidence of recurrence or metastases.
ABSTRACT
PURPOSE: This study assessed the treatment outcomes of myxoid liposarcoma in the extremities and investigate the prognostic factors. MATERIALS AND METHODS: A total of 91 patients with myxoid liposarcoma (83 primary, 8 recurrent) between 2001 and 2015 were reviewed retrospectively. The local recurrence and metastasis after treatment were examined. The survival rates and prognostic factors affecting the survival were investigated. The mean follow-up was 84 months (range, 5–196 months). RESULTS: The overall survival rates at 5-yr and 10-yr were 82% and 74%, respectively. The tumor size (p=0.04), round cell component (p<0.0001), grade (p=0.0002), and local recurrence (p=0.006) affected survival in primary patients. Extrapulmonary metastases were observed in 75.0% (18/24) of metastatic patients and the mean post metastasis survival was 26 months (range, 2–72 months). CONCLUSION: Myxoid liposarcoma developed mainly at the lower extremities. The tumor size, grade, component of round cells, and local recurrence were associated with the prognosis. The unique feature of extrapulmonary metastasis in myxoid liposarcoma should be noted in the treatment and follow-up.
Subject(s)
Humans , Cellular Structures , Extremities , Follow-Up Studies , Liposarcoma , Liposarcoma, Myxoid , Lower Extremity , Neoplasm Metastasis , Prognosis , Recurrence , Retrospective Studies , Survival RateABSTRACT
Liposarcoma is regarded as the second most common soft tissue malignant tumour. Metastasis of liposarcoma to the heart is very rare, and to date, less than 40 cases have been reported in the literature. We report a 46 year-old male with myxoid liposarcoma of the lower extremity who developed extensive metastasis to the left ventricle, pulmonary artery, and pericardium. The patient presented with acute symptoms of dyspnea 16 years after surgical resection of the primary tumour, and his dyspnea progressed to cardio-respiratory arrest within the first few days of hospital admission.
ABSTRACT
El liposarcoma mixoide es un tumor del tejido conectivo de gran malignidad, poco frecuente. Se presenta el caso clínico de una paciente de 65 años de edad, raza negra, que acudió a consulta por un cuadro clínico de dolor y aumento de volumen del muslo derecho después de tres meses de recibir un trauma en esa área. El diagnóstico inicial fue un hematoma del muslo, pero la paciente no mejoró su cuadro. Después de varios estudios se llegó a la conclusión de que la paciente tenía una tumoración maligna de gran tamaño. Esta lesión respondió bien al procedimiento quirúrgico, que consistió en cirugía exerética, con margen oncológico de seguridad, con un mínimo de dos centímetros de tejido sano con resección en bloque. Esto apoyado con la quimioterapia y radioterapia ayudaron a la no recidiva del tumor.
Myxoid liposarcoma is a few frequent connective tissue tumor of great malignancy. We present the clinical case of a black female patient aged 65 years who assisted the consultation with clinical features of pain and volume increase of the right thigh after three months of receiving a trauma in that area. The initial diagnosis was a thigh hematoma, but there was not an improvement of symptoms. After several studies we arrived to the conclusion that the patient had a great size malignant tumor. This lesion answered well to the surgical procedure consisting in an excerpting surgery, with a security oncologic margin, with a minimum of 2 cm of healthy tissue in block resection. There it was not a relapse of the tumor due to this procedure and the help of chemotherapy and radiotherapy.
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The pathological features of a mass in the back skin region of an 8-year-old castrated male dog are described herein. The cut section of the tumor was white to tan with a soft multilobulated mass containing hemorrhagic and necrotic foci and a mucinous-like composition. Microscopically, the tumor was composed of a mixture of lipocytes, lipoblasts, spindle cells and stellate cells and had a myxoid background. Oil red O staining revealed that the cytoplasm of neoplastic cells contained large numbers of lipid droplets. Immunohistochemically, tumor cells were positive for vimentin and S-100 protein. The skin mass was diagnosed as myxoid liposarcoma.
Subject(s)
Animals , Child , Dogs , Humans , Male , Adipocytes , Cytoplasm , Liposarcoma, Myxoid , S100 Proteins , Skin , Triacetoneamine-N-Oxyl , VimentinABSTRACT
El liposarcoma es una neoplasia maligna de origen mesodérmico, que incide en el 10 al 14 % de todos los sarcomas de los tejidos blandos. Representa menos del 1 % de todos los tumores malignos. Se presenta un caso que acude a consulta por pérdida de peso y sensación de plenitud gástrica. Se palpó una masa tumoral de unos 15 cm, que abombaba el hemiabdomen izquierdo, de consistencia firme, superficie lisa y bordes regulares. Se realizó ultrasonido abdominal, tomografía axial computarizada simple y contrastada del abdomen que constatan la masa tumoral. Se realizó laparotomía exploradora media abdominal, supraumbilical e infraumbilical, con exéresis total de la masa tumoral y del riñón izquierdo, el cual parecía estar infiltrado por el tumor. El estudio histopatológico de la pieza informó liposarcoma mixoide. El paciente seis meses después se mantenía asintomático, con ganancia de peso y libre de recidiva tumoral la clínica y estudios evolutivos. El liposarcoma mixoide retroperitoneal es un tumor infrecuente, que no tiene síntomas característicos. La tomografía axial computarizada constituye el estudio fundamental para el diagnóstico imaginológico. El tratamiento de elección es la exéresis total del tumor, con margen de seguridad oncológico.
Liposarcoma is a malignant neoplasia of mesodermal origin that affects 10 to14 % of all soft tissue sarcomas. It accounts for less than 1 % of all the malignant tumors. This is a patient who went to the physician's office because of weight loss and feeling of gastric plenitude. Fifteen centimeter long tumor of firm consistency, smooth surface and regular contours, which made the left hemiabdomen inflamed, was palpated. Ultrasound test of the abdomen, simple and contrasted computerized tomography of the abdominal region were performed and finally the tumor mass was detected. Additionally, supra and infraumbilical medial abdominal exploratory laparotomy was performed, with total excision of the tumor mass and of the left kidney that seemed to be affected by the tumor. The hispatological study of the sample reported the existence of myxoid liposarcoma. Six months after these procedures, the patient remained asymptomatic, gaining weight and free of tumor relapse according to the clinic and the progressive studies. Retroperitoneal myxoid liposarcoma is a rare tumor that has no characteristic symptoms. Computerized tomography is the fundamental study for the imaging-based diagnosis. The treatment of choice is total excision of tumor, with oncologic safety.
ABSTRACT
As neoplasias mediastinais de origem mesenquimal são raras, representando menos de 6% dos casos. O lipossarcoma mixoide é um tumor lipogênico originado de tecidos moles profundos e raramente de lipomas benignos. Corresponde a cerca de 50% dos lipossarcomas, e sua incidência predominante dá-se em torno dos 50 anos de idade. Pode afetar as extremidades, o retroperitônio e, menos comumente, a região da cabeça e do pescoço, cursando com massa de crescimento lento e indolor. Os autores descrevem um caso de paciente feminina de 24 anos de idade, assintomática, com uma história pregressa de acidente automobilístico há 1 ano, com exame físico sem alterações. Os exames de imagem evidenciavam uma massa pulmonar, a qual foi ressecada, e através do estudo histológico foi diagnosticado lipossarcoma mixoide
Mesenchymal mediastinal neoplasias are rare, accounting for less than 6% of cases. Myxoid liposarcoma is a lipogenic tumor originated from deep soft tissues and rarely from benign lipomas. This type of tumor accounts for about 50% of liposarcomas and it is predominantly prevalent around 50 years old. Myxoid liposarcoma can affect the extremities, retroperitoneum and, less commonly, head and neck regions, being characterized by slow growing and painless mass. We report on a case of a 24-year-old female asymptomatic patient with a history of car accident 1 year ago. Physical examination was normal. Imaging studies showed a lung mass, which was resected. Myxoid liposarcoma was diagnosed by histological examination
Subject(s)
MedicineABSTRACT
PURPOSE: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. METHODS: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. RESULTS: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. CONCLUSION: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.
Subject(s)
Female , Humans , Young Adult , Biopsy , Cheek , Follow-Up Studies , Head , Liposarcoma , Liposarcoma, Myxoid , Neck , Neoplasm Metastasis , Rare Diseases , Retroperitoneal Space , Sarcoma , ThighABSTRACT
Introduction: Primary esophageal myxoid liposarcoma is exceedingly rare. Sarcomas make up 1% of esophageal malignant tumors. There are only five (5) cases reported with this histological variant (myxoid) in previous literature. In Colombia, this is the first case reported and the sixth in the world. Objective: To report the first case in Colombia of myxoid liposarcoma of the esophagus with clinical, radiographic images, histology, surgical and to describe difficulties in the diagnosis. Methodology: We reviewed the clinical history of a 28-year old male patient. He was admitted to Hospital Universitario del Valle in Cali, Colombia with a clinical history of dysphagia, weight loss, and excessive salivation. The initial examination (esophagogram, cervical CAT scan and endoscopy) demonstrated a mass that was reported as a fibrovascular polyp. The finding of the pathological diagnosis was myxoid liposarcoma. Conclusions: The rarity of this condition recommends report of its detailed description. The myxoid liposarcoma of the esophagus can be diagnosed if a patient has a history of a slow-growing esophageal mass with a low tumor density in computed tomography in combination with surgical resection and histological examination.
Introducción: El liposarcoma mixoide es una neoplasia maligna del mesénquima con una presentación muy rara en esófago. Los sarcomas representan 1% de los tumores esofágicos malignos, y este tipo histológico es el menos frecuente. En la actualidad, se encuentran informes en la literatura de cinco (5) casos de esta variante histológica en el esófago. En Colombia, es el primer caso encontrado y el sexto (6º) a nivel mundial. Objetivo: Presentar el primer caso en Colombia de un liposarcoma mixoide en el esófago, sus características clínicas, imagenológicas, histología, manejo quirúrgico y las dificultades en su diagnóstico. Metodología: Se revisó la historia clínica de un paciente masculino de 28 años que ingresa por urgencias al Hospital Universitario del Valle en Cali, Colombia, con historia de disfagia, pérdida de peso y sialorrea. Los estudios imagenológicos como esofagograma, escanografía cervical y endoscopia de vías digestivas altas son consistentes con un pólipo esofágico y el manejo quirúrgico consistió en la resección parcial y luego la resección completa de la lesión. El informe histopatológico de la resección parcial comunicó un pólipo fibrovascular y el informe de la resección completa fue de liposarcoma mixoide. Las dificultades diagnósticas que surgieron en este caso se relacionan con otras encontradas en la literatura. Conclusiones: El liposarcoma mixoide del esófago es una entidad que presenta dificultades en su diagnóstico debido a que la presentación clínica no es específica. Aunque en estos casos las biopsias iniciales pueden suponer lesiones benignas, sólo hasta el procesamiento histológico de todo el espécimen, es posible realizar el diagnóstico de la entidad.
Subject(s)
Esophagus/abnormalities , Esophagus/surgery , Liposarcoma, Myxoid/surgery , Liposarcoma, Myxoid/epidemiology , Polyps/etiology , Sarcoma/pathologyABSTRACT
Myxoid liposarcoma is the major subtype of liposarcoma and commonly presents in the extremities, particularly in the thigh. We introduce an unusual case of a myxoid liposarcoma presenting as a large perineal swelling occupying the para-rectal and para-anal spaces in a 49-yearold male patient. The diagnosis, management, and prognosis of myxoid liposarcoma are discussed. A literature review is performed for myxoid liposarcoma.
ABSTRACT
Liposarcomas are malignant tumors of the soft tissue, with myxoid liposarcoma being the second most common subtype, tending to occur in the limbs, particularly in the thighs. Myxoid liposarcomas have an intermediate prognosis between well-differentiated and pleomorphic tumors. Spinal metastasis is usual but intradural involvement is extremely rare. We present an unusual case of a multicentric myxoid liposarcoma with intradural involvement. A 41-year-old woman complained of tingling sensation on her left arm. Radiological evaluation revealed multiple masses in her cervical spine, abdominal wall, liver, heart and right thigh, all of which were resected. She was histologically diagnosed with small round cell myxoid sarcoma and underwent adjuvant chemotherapy. However, magnetic resonance imaging analysis after 1 year revealed a large metastatic mass with bony invasion at the C6-T1 level. This mass consisted of extradural and intradural components causing severe compression of the spinal cord. She underwent resection via a posterior facetectomy of C6-7 and an anterior C7 corpectomy. However, the patient died of multiple metastases 18 months after the first diagnosis.
Subject(s)
Adult , Female , Humans , Abdominal Wall , Arm , Chemotherapy, Adjuvant , Extremities , Heart , Liposarcoma , Liposarcoma, Myxoid , Liver , Magnetic Resonance Imaging , Neoplasm Metastasis , Prognosis , Sarcoma , Sensation , Spinal Cord , Spine , ThighABSTRACT
Los tumores retroperitoneales son de gran variedad histológica y dependen del órgano o tejido del cual se derivan. Generalmente son malignos y de origen mesenquimatoso. Representan el 0,3 y 0,8 % de todas las neoplasias. El liposarcoma es el más frecuente y está entre los sarcomas más comunes en todas las localizaciones en un 25 a 35%. Se presenta caso de femenino de 31 años de edad quien acudió por aumento de volumen abdominal, con dolor en cuadrante superior derecho irradiado a espalda. En estudios paraclínicos reportan tumor retroperitoneal gigante que desplazaba órganos retroperitoneales y abdominales. Se tomó muestra por tru-cut ecoguiada que concluyó liposarcoma mixoide retroperitoneal. Se realizó extirpación quirúrgica con tratamiento adyuvante. Sin embargo a los 2 y 4 años posterior recidivó la tumoración, que ameritaron reintervención. Curso clínico desfavorable y en su seguimiento presentó derrame pleural, ascitis, trombosis venosa profunda y sepsis de punto de partida abdominal que conllevaron a su fallecimiento. En vista de lo poco frecuente de esta entidad clínica y la agresividad que representa es importante su conocimiento para el manejo multidisciplinario.
Retroperitoneal tumors are of a great histologic variety, depending mostly on the organ of origin. They are generally malignant and of mesenquimal origin. They represent 0.3 to 0.8% of all neoplasias. Liposarcoma is the most frecuently found among all sarcomas in all locations in 25 to 35%. We present the case of a 31 year old female patient who consulted presenting an increase of her abdominal volume, with right upper quadrant abdominal pain in radiated to her back. Complementary studies reported a giant retroperitoneal tumor displacing other retroperitoneales and abdominal organs. An ultrasoun guided tru-cut sample was taken that reported myxoid liposarcoma. Surgical removal of the tumor and adjuvant treatment was given to the patient. Nevertheless 2 and 4 years later the tumor reappeared requiring further surgical removal. Unfavorable clinical outcome followed , presenting pleural effusionl, ascitic fluid, deep venous thrombosis and sepsis leading to her death. This unfrequent and aggressive entity must be acknoledged and multidisciplinary handled.
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Tibial nerve compression occurs most often at the ankle. A proximal tibial nerve entrapment at the popliteal fossais rare because of the deep location of the nerve. We report a case of tibial neuropathy caused by a myxoid liposarcoma at the popliteal fossa, which was diagnosed by electrophysiologic studies, magnetic resonance imaging and an open excisional biopsy. This case illustrates that tumors should be considered when patients present with an entrapment neuropathy of the proximal tibial nerve.
Subject(s)
Animals , Humans , Ankle , Biopsy , Liposarcoma, Myxoid , Magnetic Resonance Imaging , Nerve Compression Syndromes , Tibial Nerve , Tibial NeuropathyABSTRACT
Primary myxoid liposarcoma of the heart is very rare. Following is a report on a 35 year old male presented with a huge, 8x8 cm sized mass along the inferior wall of right ventricle. The histologic diagnosis of the mass was primary myxoid liposarcoma of the pericardium. The patient died 5 months after diagnosis due to progressive dyspnea.
Subject(s)
Adult , Humans , Male , Diagnosis , Dyspnea , Heart , Heart Ventricles , Liposarcoma, Myxoid , PericardiumABSTRACT
The cytologic findings in fine needle aspiration of a case of myxoid liposarcoma of the mediastinum are described. The smear and cell block of the aspirate revealed solid clusters with background of amorphous material and scattered single tumor cells. The clusters were moderately cellular and consisted of atypical lipoblasts in varying stages of differentiation and delicate plexiform capillaries. Good correlation was found between the histologic and cytologic findings in the fine needle aspirates. The differential diagnosis between myxoid liposarcoma and other myxoid soft tissue tumors is discussed,
Subject(s)
Humans , Biopsy, Fine-Needle , Capillaries , Diagnosis, Differential , Liposarcoma, Myxoid , Mediastinum , Needles , Neural Tube Defects , Urological ManifestationsABSTRACT
The cytologic findings in fine needle aspiration of a case of myxoid liposarcoma of the mediastinum are described. The smear and cell block of the aspirate revealed solid clusters with background of amorphous material and scattered single tumor cells. The clusters were moderately cellular and consisted of atypical lipoblasts in varying stages of differentiation and delicate plexiform capillaries. Good correlation was found between the histologic and cytologic findings in the fine needle aspirates. The differential diagnosis between myxoid liposarcoma and other myxoid soft tissue tumors is discussed.