Primary Dedifferentiated Liposarcoma of the Axilla Arising in a Mixed, Well-differentiated and Myxoid Liposarcoma

ArticleinJournal of Radiology Case Reports 6(1):9-16 · January 2012with14 Reads
DOI: 10.3941/jrcr.v6i1.867 · Source: PubMed
Abstract
We describe a case of mixed liposarcoma of the axilla presenting as a high grade undifferentiated sarcoma with areas of well-differentiated and myxoid liposarcoma. MRI demonstrated a lobulated, septated intermuscular mass with marked heterogeneous gadolinium enhancement. A small focus of the tumor demonstrated fat suppressed signal more characteristic of well-differentiated liposarcoma. Pathologic analysis following wide local excision revealed a large, high grade sarcomatous component with highly pleomorphic cells with a thin rim of well-differentiated and myxoid liposarcoma on histologic examination. Dedifferentiated liposarcomas arising outside of the retroperitoneum are very rare, as are dedifferentiated liposarcomas arising from a histologically mixed liposarcoma. In this regard, this case illustrates an unusual combination of tumor location and histology which, to our knowledge, has not previously been reported.
    • "Some authors have reported that postoperative adjuvant radioterapy lengthens the median survival rate when surgical excision has not been adequate [7,8,10]. Giant lipoma treatment can be by open surgical excision or by liposuction, but it is very important to choose the most appropriate operative technique, considering the possibility of malignant transformation [12]. Fine needle aspiration biopsy and core biopsy usually do not provide sufficient material to allow the pathologist to differentiate between lipoma and liposarcoma [11]. "
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    • "After consulting the surgeon we came to the conclusion that the original tissue of the sarcoma was most probably the axilla ligament where the tumor had a consistent base. We found only one report about sarcoma in this localization, but the histological type was different liposarcoma (Manabe et al., 2005; Davidescu et al., 2011; Campbell et al., 2012). "
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