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1.
Am J Case Rep ; 23: e934586, 2022 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-34996885

RESUMO

BACKGROUND Gastric carcinoma (GC) remains one of the most common and deadly neoplasms in the world. Liposarcoma (LPS) is the most common sarcoma of adults. However, synchronous or metachronous occurrence of GC with LPS seems to be very rare. Tumor staging and differential diagnosis with these cases are extremely difficult. CASE REPORT The patient was a man in his 70s, who reported anorexia and weight loss of 4 kg over 2 months. Gastroscopy demonstrated a large tumor of Borrmann type 3, of which histology was moderately to poorly differentiated adenocarcinoma. The clinical stage was initially defined as IVb due to a 11×6 cm retroperitoneal (RP) tumor. Despite chemotherapy for GC, the RP tumor rapidly enlarged. Endoscopic ultrasound-guided fine-needle aspiration biopsy showed that it was an undifferentiated sarcoma. He died of hepatorenal failure secondary to severe jaundice. The autopsy revealed a synchronous occurrence of GC and RP sarcoma. GC had no areas admixed with sarcoma. Histology of RP sarcoma showed that it mainly consisted of undifferentiated sarcoma and focally of well-differentiated LPS characterized by well-differentiated adipocytes admixed with scattered atypical stromal cells. The tumor cells in both areas were positive for MDM2 and CDK4 by immunohistochemistry. The diagnosis of the RP sarcoma was revised to dedifferentiated LPS. CONCLUSIONS There were no previous case reports of synchronous occurrence of GC with LPS in the English and Japanese literature. GC and LPS pose challenging problems in their diagnoses, staging, and treatments when they occur synchronously or metachronously.


Assuntos
Carcinoma , Lipossarcoma , Neoplasias Retroperitoneais , Neoplasias Gástricas/diagnóstico , Idoso , Carcinoma/diagnóstico , Humanos , Imuno-Histoquímica , Lipossarcoma/diagnóstico , Masculino , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Retroperitoneais/diagnóstico
2.
Zhonghua Bing Li Xue Za Zhi ; 51(1): 17-22, 2022 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-34979748

RESUMO

Objective: To investigate the clinicopathological features and differential diagnoses of paratesticular liposarcoma. Methods: The cases were collected from 2012-2020, from the archives of the Department of Pathology, Peking University Third Hospital, with diagnosis confirmed by histology, immunostaining and FISH tests. Results: Totally 19 patients were enrolled (including 11 in-hospital patients and 8 consultant cases). The patients aged 37-84 years (mean 57 years). The preoperative clinical diagnoses were spermatic cord/inguinal masses (nine patients), scrotal masses (seven patients), and inguinal hernia (three patients). Six lesions recurred after local resection, including one case extending from pelvic liposarcoma. Histologically, there were 10 cases of well-differentiated liposarcoma (WDLPS) and nine cases of dedifferentiated liposarcoma (DDLPS). WDLPSs mostly showed the combined features of lipoma-like, inflammatory and sclerosing subtypes (six patients); the other four WDLPSs had pure lipoma-like subtype features. DDLPSs were low-grade (three patients) or high-grade (six patients), with the morphology resembling myxofibrosarcoma, inflammatory myofibroblastoma, spindle cell sarcoma, pleomorphic undifferentiated sarcoma and pleomorphic liposarcoma. Intense inflammatory cells infiltration was commonly observed in five WDLPSs and two DDLPSs. Ossification was observed in three tumors. Immunohistochemically, the tumors were positive for MDM2 (8/10) and CDK4 (10/10), which were expressed in lipo-differentiating cells, spindle cells in WDLPS, and in dediffferentiated components. S-100 was only expressed by lipocytes (10/10). CD34 expression was positive and diffuse in the stromal cells of WDLPSs and focal or diffuse in dedifferentiated areas (10/10). FISH tests with an MDM2 gene probe were positive (12/12). Conclusions: Paratesticular liposarcoma may be overlooked by both clinicians and pathologists. WDLPS and DDLPS predominate, showing various histologic divergences. The presence of amplification of the 12q14-q15 region (containing the MDM2 and CDK4 genes) is helpful for making the correct diagnosis.


Assuntos
Neoplasias dos Genitais Masculinos , Lipossarcoma , Neoplasias de Tecidos Moles , Adulto , Neoplasias dos Genitais Masculinos/cirurgia , Humanos , Hibridização in Situ Fluorescente , Lipossarcoma/genética , Lipossarcoma/cirurgia , Masculino , Proteínas Proto-Oncogênicas c-mdm2/genética
3.
Clin Nucl Med ; 47(1): 70-72, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34034329

RESUMO

ABSTRACT: Liposarcoma is a soft tissue tumor that commonly appears in the retroperitoneum and the extremities. Herein, we presented the imaging findings of a 68-year-old man with a paravertebral liposarcoma involving the adjacent vertebral bodies, appendices, and ribs. MRI revealed this mass located in the left side of T9 to T10 vertebral bodies. FDG PET/CT demonstrated the mass with intense FDG uptake. Finally, the pathological findings were consistent with a diagnosis of a primary paravertebral liposarcoma.


Assuntos
Lipossarcoma , Neoplasias de Tecidos Moles , Idoso , Fluordesoxiglucose F18 , Humanos , Lipossarcoma/diagnóstico por imagem , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons
4.
Clin Nucl Med ; 47(1): e98-e100, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183499

RESUMO

ABSTRACT: Granulocyte colony-stimulating factor (G-CSF)-producing tumors are malignant tumors associated with a poor prognosis, and G-CSF-producing liposarcoma is particularly rare. We report a case of G-CSF-producing dedifferentiated liposarcoma. 18F-FDG PET/CT showed abnormal 18F-FDG uptake throughout the bone marrow and in the primary site. When a diffuse bone marrow 18F-FDG uptake was observed on 18F-FDG PET/CT, G-CSF-producing dedifferentiated liposarcoma should be included in the differential diagnosis.


Assuntos
Fluordesoxiglucose F18 , Lipossarcoma , Fator Estimulador de Colônias de Granulócitos , Humanos , Lipossarcoma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos
5.
Nutrients ; 13(12)2021 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-34959824

RESUMO

The molecular pathophysiology of cardiometabolic diseases is known to be influenced by dysfunctional ectopic adipose tissue. In addition to lifestyle improvements, these conditions may be managed by novel nutraceutical products. This study evaluatedthe effects of 11 Cameroonian medicinal spice extracts on triglyceride accumulation, glucose uptake, reactive oxygen species (ROS) production and interleukin secretion in SW 872 human adipocytes after differentiation with 100 µM oleic acid. Triglyceride content was significantly reduced by all spice extracts. Glucose uptake was significantly increased by Tetrapleura tetraptera, Aframomum melegueta and Zanthoxylum leprieurii. Moreover, Xylopia parviflora, Echinops giganteus and Dichrostachys glomerata significantly reduced the production of ROS. Concerning pro-inflammatory cytokine secretion, we observed that Tetrapleura tetraptera, Echinops giganteus, Dichrostachys glomerata and Aframomum melegueta reduced IL-6 secretion. In addition, Xylopia parviflora, Monodora myristica, Zanthoxylum leprieurii, and Xylopia aethiopica reduced IL-8 secretion, while Dichrostachys glomerata and Aframomum citratum increased it. These findings highlight some interesting properties of these Cameroonian spice extracts in the modulation of cellular parameters relevant to cardiometabolic diseases, which may be further exploited, aiming to develop novel treatment options for these conditions based on nutraceutical products.


Assuntos
Adipócitos/metabolismo , Suplementos Nutricionais , Síndrome Metabólica/terapia , Extratos Vegetais/farmacologia , Especiarias/análise , Linhagem Celular Tumoral , Glucose/metabolismo , Humanos , Interleucinas/metabolismo , Lipossarcoma , Espécies Reativas de Oxigênio/metabolismo , Triglicerídeos/metabolismo
6.
Kyobu Geka ; 74(12): 996-999, 2021 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-34795141

RESUMO

An anterior mediastinal tumor was detected by computed tomography (CT) in a 66-year-old man who complained of left flank pain, and the surgical treatment was performed. At surgery, partial resection of the pericardium was also conducted because the pericardial inversion was suspected. The histopathological diagnosis was dedifferentiated liposarcoma. The patient is well without adjuvant chemotherapy 23 months after the surgery.


Assuntos
Lipossarcoma , Neoplasias do Mediastino , Idoso , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Mediastino , Pericárdio/diagnóstico por imagem , Pericárdio/cirurgia , Tomografia Computadorizada por Raios X
7.
Khirurgiia (Mosk) ; (11): 5-11, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34786910

RESUMO

OBJECTIVE: To assess the influence of active surgical approach on the long-term postoperative outcomes in patients with retroperitoneal liposarcoma. MATERIAL AND METHODS: A retrospective study included 190 patients with retroperitoneal liposarcoma. The effect of malignancy grade, adjuvant chemotherapy, number of separate tumor nodes in primary neoplasm and the first relapse, as well as the number of previous total resections on survival rate was analyzed. RESULTS: Overall and relapse-free survival is significantly worse in patients with high-grade retroperitoneal liposarcoma (G2-3) compared to low-grade (G1) tumor (plog-rank=0.000). Multifocal growth of primary tumor (p=0.869; plog-rank=0.607) and multiple (>1) separately located nodes in abdominal cavity and retroperitoneal space at the first relapse (plog-rank=0.158 to 0.985) did not significantly impair prognosis after total resection of all types of retroperitoneal liposarcoma regardless malignancy grade. Adjuvant chemotherapy does not significantly improve relapse-free survival. Overall survival was significantly higher in patients who underwent ≥4 previous total resections compared to 1 surgical treatment for all types of retroperitoneal liposarcoma regardless malignancy grade (p=0.000; plog-rank=0.001). CONCLUSION: The only potentially radical treatment for patients with retroperitoneal liposarcoma is surgery. We reported the advantages of active surgical approach for improvement of long-term outcomes in patients with retroperitoneal liposarcoma.


Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Humanos , Lipossarcoma/diagnóstico , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/cirurgia , Estudos Retrospectivos
8.
Rom J Morphol Embryol ; 62(1): 125-132, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34609415

RESUMO

Our article presents some of the challenges of the surgical treatment of T4 (>15 cm) retroperitoneal liposarcomas (up to 65∕56∕30 cm, 25.5 kg) series of cases treated by the Department of Surgical Oncology, Prof. Dr. Ion Chiricuta Oncology Institute, Cluj-Napoca (IOCN), Romania, with illustrations, insisting on important blood vessels and nerves dissection and preservation and discussions of strategies with references to important articles from the last 10 years specialty literature. Challenges do not come only from intraoperative difficulties but also from establishing the right attitude from the extent of resection and oncological safety point of view, the role of the pathologist being very important because histological subtype and completeness of the resections are the most important prognostic factors for such tumors. Despite all today available aids in decision making, like nomograms or high-resolution imagery, sometimes this decision is to be taken intraoperative based on surgeon's expertise and skills. That is why is strongly advised that such cases to be treated in high-volume specialized tertiary centers of surgical oncology.


Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Lipossarcoma/cirurgia , Neoplasias Retroperitoneais/cirurgia
9.
Rom J Morphol Embryol ; 62(1): 301-307, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34609436

RESUMO

Liposarcoma of the breast is a very rare soft tissue malignant tumor arising in the fat cells, with a prevalence of 0.3% of all malignant breast tumors, clinically manifested as a palpable breast mass mimicking a primary breast cancer. In the present paper, we had two objectives: (i) to report the first liposarcoma case in our Clinic and (ii) to screen the scientific literature on the topic. Our report presents an unusual case of a 56-year-old female with symptomatic left breast mass initially histopathologically diagnosed as a mesenchymal lesion. Four months later, the tumor was histopathologically identified as a grade 3 dedifferentiated liposarcoma (DDLPS) Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC; French Federation of Cancer Centers). We present the histopathological, immunohistochemical, and radiological features of the case and outcomes. Secondly, we performed a systematic search on liposarcoma on the PubMed®∕Medline® and Web of Science® databases, using the keyword "primary breast liposarcoma" (all-time topic). Due to the small number of cases found in the literature, the best treatment choice and determination of prognosis are difficult to make. Our patient underwent breast radical surgery, received adjuvant treatment, continuously monitored, being disease-free after five years of follow-up.


Assuntos
Lipossarcoma , Feminino , Humanos , Lipossarcoma/diagnóstico , Pessoa de Meia-Idade , Prognóstico
10.
Ann Ital Chir ; 102021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34569472

RESUMO

AIM: Sarcomas are rare tumors representing 0.7% of all cancer cases in adults, and approximately 15-20% of those occur in the retroperitoneum. Diagnosis is usually late. Liposarcoma and leiomyosarcoma are the most frequent forms. Liposarcomas have high local recurrence rates (35-60%) and a high metastasis rate only if dedifferentiated (30%), whereas leiomyosarcoma has a high distant metastasis rate (60%) and a low local recurrence rate (20%). CASE REPORT: A case report of multifocal synchronous well-differentiated liposarcoma is presented. The patient underwent a surgical excision of all the masses. The postoperative period was uneventful, with a postoperative hospital stay of 9 days. The patient underwent systemic chemotherapy and clinical and instrumental follow-up. A relapse of the disease was observed 24 months after surgery: a 25 mm mass was diagnosed close to the pancreatic stump, as well as a 24 mm mass in the left upper abdominal quadrant. The patient underwent a second laparotomy: recurrent lesions were identified and excised en-bloc with the body of the pancreas. CONCLUSION: Surgery is the gold standard of therapy. The best chance for curative resection is at the time of the first diagnosis of the disease. Compartmental surgery is a macroscopically complete resection through en bloc excision of adjacent structures, even if not clearly infiltrated. Many controversies still exist in the treatment of retroperitoneal liposarcoma, such as the extent of primary and secondary resections, the benefit of chemotherapy and radiation therapy, and when these treatments should be delivered. KEY WORDS: Compartmental surgery, Liposarcoma, Surgery, Retroperitoneal sarcoma.


Assuntos
Leiomiossarcoma , Lipossarcoma , Neoplasias Retroperitoneais , Adulto , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia
11.
J Int Med Res ; 49(9): 3000605211041269, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34525883

RESUMO

Oesophageal liposarcomas are particularly rare, accounting for 1.2-1.5% of all gastrointestinal liposarcomas. Surgical resection is the usual treatment. Endoscopic resection is minimally invasive but still controversial. This current case report describes a rare case of a large oesophageal liposarcoma in a 52-year-old male that presented with 10-year history of dysphagia for dry and solid food that was exacerbated by a recent common cold. Thoracoscopic and laparoscopic oesophagectomy was performed. He did not have any dysphagia or dyspnoea 1 week postoperatively. The excised specimen consisted of a polypoid mass measuring 21.0 cm × 5.1 cm. Histological examination confirmed that it was an oesophageal liposarcoma. At 1-year postoperatively, there was no sign of recurrence. Thoracoscopy and laparoscopy can be used to treat large oesophageal masses. Long-term follow-up is required as oesophageal liposarcomas tend to recur.


Assuntos
Neoplasias Esofágicas , Laparoscopia , Lipossarcoma , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/cirurgia , Esofagectomia , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia
12.
Acta Orthop Belg ; 87(2): 243-246, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34529376

RESUMO

The objective of the study is aimed to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location.


Assuntos
Lipoma , Lipossarcoma , Neoplasias de Tecidos Moles , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Lipoma/cirurgia , Masculino , Recidiva Local de Neoplasia , Estudos Retrospectivos , Neoplasias de Tecidos Moles/cirurgia
13.
Int J Surg Oncol ; 2021: 2626635, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34518784

RESUMO

Introduction: Gastrointestinal stromal tumors (GISTs) quite frequently occur synchronously with other malignancies, with most cases being adenocarcinomas. GISTs and liposarcomas are both of mesenchymal origin, and their coexistence is extremely rare. Methods: We conducted a review of the current literature regarding the synchronous occurrence of GISTs and intra-abdominal liposarcomas. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). Furthermore, we present the first described case of an 86-year-old male with a GIST and synchronous liposarcoma, both located in the stomach, as well as a 66-year-old male with a gastric GIST and concurrent retroperitoneal liposarcoma. Results: A total of 5 cases of synchronous GIST and intra-abdominal liposarcoma have been reported in the literature to date, with the most recent cases included in the present study. Conclusion: Further research is required to explain any possible correlation in the coexistence of these different neoplasms of the same origin. Meanwhile, R0 resection of both tumors remains the treatment of choice.


Assuntos
Tumores do Estroma Gastrointestinal , Lipossarcoma , Neoplasias Retroperitoneais , Neoplasias Gástricas , Adenocarcinoma , Idoso , Idoso de 80 Anos ou mais , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia
14.
Ann Ital Chir ; 92: 419-423, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34524112

RESUMO

AIM: Sarcomas are rare tumors representing 0.7% of all cancer cases in adults, and approximately 15-20% of those occur in the retroperitoneum. Diagnosis is usually late. Liposarcoma and leiomyosarcoma are the most frequent forms. Liposarcomas have high local recurrence rates (35-60%) and a high metastasis rate only if dedifferentiated (30%), whereas leiomyosarcoma has a high distant metastasis rate (60%) and a low local recurrence rate (20%). CASE REPORT: A case report of multifocal synchronous well-differentiated liposarcoma is presented. The patient underwent a surgical excision of all the masses. The postoperative period was uneventful, with a postoperative hospital stay of 9 days. The patient underwent systemic chemotherapy and clinical and instrumental follow-up. A relapse of the disease was observed 24 months after surgery: a 25 mm mass was diagnosed close to the pancreatic stump, as well as a 24 mm mass in the left upper abdominal quadrant. The patient underwent a second laparotomy: recurrent lesions were identified and excised en-bloc with the body of the pancreas. CONCLUSION: Surgery is the gold standard of therapy. The best chance for curative resection is at the time of the first diagnosis of the disease. Compartmental surgery is a macroscopically complete resection through en bloc excision of adjacent structures, even if not clearly infiltrated. Many controversies still exist in the treatment of retroperitoneal liposarcoma, such as the extent of primary and secondary resections, the benefit of chemotherapy and radiation therapy, and when these treatments should be delivered. KEY WORDS: Compartmental surgery, Liposarcoma, Surgery, Retroperitoneal sarcoma.


Assuntos
Leiomiossarcoma , Lipossarcoma , Neoplasias Retroperitoneais , Adulto , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia
17.
Acta Clin Croat ; 60(1): 50-54, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34588721

RESUMO

Liposarcoma of the spermatic cord is a malignant tumor so rare that there are less than 200 cases reported in the literature worldwide. Liposarcoma is a malignancy which originates from fat tissue. Although only 3%-7% of all paratesticular sarcomas primarily arise from structures of the spermatic cord, clinical significance of these tumors must not be neglected because they are often preoperatively misdiagnosed. A 66-year-old male presented with a painless swelling on the left side of the scrotum. Local examination revealed a solid, smooth, limited mass of approximately 4x3 cm in the left side of the scrotum. Tumor markers were within the reference range. Ultrasound examination showed a solid, clearly limited non-homogeneous mass of 40x20 mm localized in the left spermatic cord. Magnetic resonance imaging showed an expansive mass measuring 60x85x60 mm in the left inguinoscrotal region without propagation into the abdominal cavity. Both testicles and epididymides appeared normal on magnetic resonance examination and no locoregional enlarged lymph nodes were seen. The patient was treated operatively with radical inguinal orchiectomy. In conclusion, liposarcomas of the spermatic cord are extremely rare neoplasms that clinically present as slow-growing, painless, palpable inguinal or scrotal masses. Radical orchiectomy with high ligation of the spermatic cord and wide excision of the surrounding soft tissues within the inguinal canal remains the gold standard treatment option. Recurrence of the disease is frequent even several years after primary therapy, therefore long-term follow-up is mandatory.


Assuntos
Neoplasias dos Genitais Masculinos , Lipossarcoma , Cordão Espermático , Idoso , Neoplasias dos Genitais Masculinos/diagnóstico por imagem , Neoplasias dos Genitais Masculinos/cirurgia , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Masculino , Recidiva Local de Neoplasia , Orquiectomia , Cordão Espermático/diagnóstico por imagem , Cordão Espermático/cirurgia
19.
In Vivo ; 35(5): 2779-2783, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34410968

RESUMO

BACKGROUND: Liposarcoma of the larynx is a rare entity. Well-differentiated spindle cell liposarcoma of the larynx has not been yet reported in the literature. CASE REPORT: We report the first case of well-differentiated spindle cell liposarcoma of the larynx on a 59-year-old male who presented with change of voice and phlegmy cough for several months. Laryngoscopy revealed a mucosal covered pedunculated mass on the supraglottis. Computerized tomography (CT) scan showed a low-attenuation mass causing moderate narrowing of the airway. The lesion was excised. Grossly, a 4.2 cm ovoid, solid and soft mass with homogeneously white-gray and rubbery cut surface was identified. Microscopic examination revealed a well-demarcated neoplasm composed of predominantly atypical and pleomorphic spindle cells distributed in collagenous stroma, with admixed adipocytes showing variation in cell size and rare lipoblasts. Immunohistochemical stains showed that the spindle cells were positive for MDM2, CDK4, and CD34. Overall, the histology and immunoprofile are consistent with a well-differentiated liposarcoma, spindle cell type. Due to the positive resection margin, the patient subsequently received endoscopic local re-excision with a carbon dioxide laser. He did well at 4 months after primary excision. CONCLUSION: This case illustrates that while well-differentiated spindle cell liposarcoma rarely occurs in the larynx, it should be considered in the differential diagnosis of patients with laryngeal lesions. A panel of immunohistochemistry markers including MDM2, CDK4 and CD34 is helpful to render accurate diagnosis. Wide excision with long-term follow-up is necessary for this rare variant of liposarcoma.


Assuntos
Laringe , Lipoma , Lipossarcoma , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Lipossarcoma/diagnóstico , Lipossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade
20.
Ann R Coll Surg Engl ; 103(8): e255-e258, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34464560

RESUMO

Liposarcoma is one of the most common soft tissue malignancies, occurring mostly in the extremities and retroperitoneal cavities, and occasionally in the mediastinum of the thoracic cavity. Here, we present a patient undergoing four operations over a period of 33 years because of repeated recurrence of mediastinal liposarcoma. A 34-year-old woman underwent her first surgery for mediastinal liposarcoma in 1986. Ten years later, a recurrent tumour was found during follow-up. The patient underwent a second operation for complete excision. The pathology was liposarcoma, partly myxoid and partly dedifferentiated. The patient remained tumour-free for 22 years, until one year ago, when a third operation was performed to resect the recurrent tumour which was myxoid liposarcoma. Unfortunately, upon computed tomography imaging three months later a fatty mass was spotted which increased rapidly in size. The patient underwent further surgery to achieve radical excision of the recurrent liposarcoma. Postoperative recovery was uneventful, and a follow-up examination showed no recurrence to date. For mediastinal liposarcoma, surgical removal is the treatment of choice. Considering that the tumour is prone to recurrence, the lesion should be removed as thoroughly as possible in the first operation. If the tumour recurs repeatedly, multiple resections are beneficial to patient survival on most occasions.


Assuntos
Lipossarcoma/cirurgia , Neoplasias do Mediastino/cirurgia , Recidiva Local de Neoplasia/cirurgia , Adulto , Feminino , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/patologia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia , Tomografia Computadorizada por Raios X
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