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High-grade dedifferentiated liposarcoma with heterologous elements (neural and osteoid differentiation) and rhabdomyoblastic-like features in a 37-year-old male: a case report and review of literature
5th World Congress on Surgical Pathology and Oncology Research
May 08, 2023 | Webinar
Katrina Jezzela M Dela Pena and Azenith May H Rafanan
Jose B. Lingad Memorial General Hospital, Philliphines
Scientific Tracks Abstracts : J Clin Path Lab Med
Abstract:
To report the least common type of liposarcoma, dedifferentiated liposarcoma of the extremities of a 37-year-old man diagnosed by wide excision biopsy and a panel of immunohistochemistry staining and review related literature of this disease entity. Clinical Features: The patient had a 5-month history of progressively enlarging right axillary mass with an initial biopsy result of spindle cell neoplasm with epithelioid features. Methods: Review all the data that include the patient’s history, radiographic, histopathologic and immunohistochemically findings. Results and Conclusions: Wide excision biopsy was done which yielded slides showing neoplastic cells in sheets and nests in a fibromyxoid stroma with areas of osteoid formation. The individual neoplastic cells are pleomorphic, exhibiting ample to scant cytoplasm with no distinct cell margins with large round to oval nuclei with marked atypia, prominent nuclei, multivacoulated cells with indented nuclei and prominent nucleoli identified as lipoblasts, large pleomorphic cells with abundant tapered eosinophilic cytoplasm, and spindle shaped cells with large nuclei. No evidence of lymphovascular invasion. All lines of resection are negative for the tumor. Immunohistochemistry (IHC) staining with CD99 and Murine Double Minute 2 (MDM2) shows a positive reactivity to the tumor. Cytokeratin (CK) and S100, Myogenin, MYO-D1 showed no reactivity. Ki67 shows a proliferative index of 60-65%, a high proliferative index. The histomorphologic and immunohistochemical (IHC) features were compatible with High-Grade Dedifferentiated Liposarcoma with Heterologous elements (neural and osteoid differentiation) and rhabdomyoblastic features. Patient then underwent 35 cycles of radiation therapy and 6 cycles of chemotherapy. Patient has no tumor recurrence upon follow up. Dedifferentiated Liposarcoma poses a diagnostic challenge, its Morphological differentiation can be difficult as it can mimic benign or other malignant lesions which differ in treatment and prognosis.
Biography:
David J has completed his/her PhD at the age of 25 years from Duke University, USA. He/she is the director/professor of Duke University, USA. He/she has over 200 publications that have been cited over 200 times, and his/her publication H-index is 20 and has been serving as an editorial board member of reputed Journals.
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