PDF
ePub
Citation
Print
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.
References
1. Son BS, Seok SJ, Chung SK, et al. A case of liposarcoma arising in the mesentery. Korean J Gastroenterol. 2009; 54:243–247.
2. Cho YJ, Chun HJ, Park DK, et al. A case of dedifferentiated liposarcoma in retroperitoneum. Korean J Med. 2002; 62:552–556.
3. Jain SK, Mitra A, Kaza RC, Malagi S. Primary mesenteric liposarcoma: An unusual presentation of a rare condition. J Gastrointest Oncol. 2012; 3:147–150.
4. Grifasi C, Calogero A, Carlomagno N, Campione S, D'Armiento FP, Renda A. Intraperitoneal dedifferentiated liposarcoma showing MDM2 amplification: case report. World J Surg Oncol. 2013; 11:305.
5. Shen Z, Wang S, Fu L, et al. Therapeutic experience with primary liposarcoma from the sigmoid mesocolon accompanied with well-differentiated liposarcomas in the pelvis. Surg Today. 2014; 44:1863–1868.
6. Liu Y, Ishibashi H, Sako S, et al. A giant mesentery malignant soli-tary fibrous tumor recurring as dedifferentiated liposarcoma- a report of a very rare case and literature review. Gan To Kagaku Ryoho. 2013; 40:2466–2469.
7. Eltweri AM, Gravante G, Read-Jones SL, Rai S, Bowrey DJ, Haynes IG. A case of recurrent mesocolon myxoid liposarcoma and review of the literature. Case Rep Oncol Med. 2013; 2013:692754.
8. Khan MI, Zafar A, Younas M, Malik I. Huge mesenteric liposarcoma. J Pak Med Assoc. 2013; 63:775–777.
9. Garg PK, Jain BK, Dahiya D, Bhatt S, Arora VK. Mesenteric liposarcoma: report of two cases with review of literature. J Gastrointest Cancer. 2014; 45(Suppl 1):170–174.
10. Gebhard S, Coindre JM, Michels JJ, et al. Pleomorphic liposarcoma: clinicopathologic, immunohistochemical, and fol-low-up analysis of 63 cases: a study from the French Federation of Cancer Centers Sarcoma Group. Am J Surg Pathol. 2002; 26:601–616.
11. Dalal KM, Kattan MW, Antonescu CR, Brennan MF, Singer S. Subtype specific prognostic nomogram for patients with primary liposarcoma of the retroperitoneum, extremity, or trunk. Ann Surg. 2006; 244:381–391.
12. Dubin MR, Chang EW. Liposarcoma of the tongue: case report and review of the literature. Head Face Med. 2006; 2:21.
13. Choi CW, Kim ST, Kim HJ, et al. Myxoid Liposarcoma of the Parietal Peritoneum. Korean J Gastroenterol. 1999; 33:298–302.
14. Ishiguro S, Yamamoto S, Chuman H, Moriya Y. A case of resected huge ileocolonic mesenteric liposarcoma which responded to pre-operative chemotherapy using doxorubicin, cisplatin and ifosfamide. Jpn J Clin Oncol. 2006; 36:735–738.
15. Nakamura A, Tanaka S, Takayama H, et al. A mesenteric liposarcoma with production of granulocyte colony-stimulating factor. Intern Med. 1998; 37:884–890.
Fig. 1.
(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.
Fig. 2.
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.
Table 1.
Pubilished Pleomorphic Liposarcoma of Mesentery
XML Download