KjG The Korean Journal of Gastroenterology Korean J Gastroenterol 1598-9992 2233-6869 Korean Society of Gastroenterology 10.4166/kjg.2015.65.3.182 kjg-65-182 Case Report A Case of Pleomorphic Liposarcoma Originating from Mesentery ChoiJin Young KimJi Eun LeeSeung Min KangHo Jun SungJi Hee KohByung Sung ParkJu Sang KimIl Dong 1 BaikSo Ya 2 Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea Department of Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea Department of Pathology, Bundang Jesaeng General Hospital, Seongnam, Korea Correspondence to: Ju Sang Park, Department of Internal Medicine, Bundang Jesaeng General Hospital, 20 Seohyeon-ro 180beon-gil, Bundang-gu, Seongnam 463- 774, Korea. Tel: +82-31-779-0209, Fax: +82-31-779-0897, E-mail: parkjs@dmc.or.kr 10 2015 04 10 2015 65 3 182 185 12082014 04092014 11092014 Copyright © 2015 Korean Ophthalmological Society 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Liposarcoma is one of the most common soft tissue sarcomas that occurs in adults and is currently divided into five main subgroups: well-differentiated, myxoid, round cell, pleomorphic, and dedifferentiated. Primary mesenteric liposarcoma is extremely rare, and the treatment strategy is surgical resection with a wide free margin, often followed by radiation and adjuvant chemotherapy if distant metastasis is not detected. A 73-year-old male patient presented with lower abdominal distension. Abdominal CT scan revealed a large homogeneously enhancing mass lesion abutting the sigmoid colon and urinary bladder. At laparotomy, the solid mass measured 28×26×12 cm in size, was well-demarcated, and originated from the mesentery of the middle ileum. It was removed along with some small intestine (ileocecal valve upper 50–150 cm) and ileal mesentery because of adhesion. Histologically, the tumor proved to be pleomorphic liposarcoma. The patient did not undergo any adjuvant treatment following surgery, but he remains disease free until 33 months after surgery. Herein, we report a case of pleomorphic liposarcoma arising from small bowel mesentery.

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(A, B) Pre-operative enhanced computed tomography findings. The peritoneal cavity is almost occupied by heterogeneously enhancing huge mass measuring about 25×10 cm with multiple area of necrosis and inseparable from the sigmoid colon. (C, D) Post-operative enhanced computed tomography taken at 25 month after surgical extirpation. Intra-abdominal structures are normal and there is no evidence of recurrence.

Gross and microscopic findings (H&E, ×100). (A) A yellowish hard solid multinodular mass originating from the small bowel mesentery measures 28×26×12 cm in size (arrows). (B) Tumor shows a thick fibrous capsule.(C) Pleomorphic spindle-shaped cells and multinucleated giant lipoblasts with floret-like features (arrows) are seen.

Pubilished Pleomorphic Liposarcoma of Mesentery

Authors Year Age (yr)/ sex Clinical presentation Involved bowel Size (cm) Treatment Follow-up Prognosis
Jain et al.3 2012 50/M Abdominal distension Jejunem 20×20 Surgical excision - -
Nakamura et al.15 1998 82/F Pyrexia Ileocecal colon 10.5×7×7 Surgical excision 7 months Disease free
Present case 2014 73/M Palpable Sigmoid colon 28×26×12 Surgical excision 33 months Disease free
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