RESUMO
It is important to distinguish between leiomyosarcoma (LMS) and dedifferentiated liposarcoma (DDLS) in the retroperitoneum. The dedifferentiated component of DDLS shows an LMS-like morphology in some cases; thus, detailed evaluation is necessary to achieve an accurate diagnosis. Immunohistochemically, MDM2 and myogenic markers provide clues for the diagnoses. However, immunoreactivity for MDM2 and myogenic markers has not been well studied in retroperitoneal LMS and DDLS. Here, we compared the clinicopathological data of 20 retroperitoneal tumors initially diagnosed as LMS with that of 36 cases of retroperitoneal DDLS and conducted an immunohistochemical study. Four (20%) of the cases initially diagnosed as LMS were immunoreactive for MDM2. Fifteen cases (41.7%) of DDLS showed positive expression of two or more myogenic markers. The patients with LMS with MDM2 overexpression were older than the patients with LMS without MDM2 overexpression (P=0.0328). LMS with MDM2 overexpression showed a worse prognosis than DDLS (P=0.0408). No significant difference in prognosis was found between LMS without MDM2 overexpression and DDLS with myogenic differentiation. In conclusion, we recommend that systemic MDM2 expression analysis be performed in cases of retroperitoneal sarcoma. Overdependence on the expression of myogenic markers could lead to misdiagnosis in distinguishing LMS from DDLS.
Assuntos
Leiomiossarcoma/diagnóstico , Lipossarcoma/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Diagnóstico Diferencial , Feminino , Humanos , Leiomiossarcoma/metabolismo , Leiomiossarcoma/patologia , Lipossarcoma/metabolismo , Lipossarcoma/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Neoplasias Retroperitoneais/metabolismo , Neoplasias Retroperitoneais/patologiaRESUMO
We constructed an arm holder for muscle exercise from a forearm-shaped plastic shell and magnetic resonance (MR) imaging position markers and determined the echo time (39 ms) for T2-weighted spin-echo MR imaging from T2values of the exercised (50 ms) and resting (32 ms) muscle at 0.2 tesla. The smallest detectable muscle was the extensor digiti minimi muscle (cross-sectional area 25 mm²). This combination could be useful to monitor finger exercise in patients undergoing physical therapy.
