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Japanese Journal of Clinical Oncology 2006 36(7):462-467; doi:10.1093/jjco/hyl073
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© 2006 Foundation for Promotion of Cancer Research

Case Report

Surgery for Dedifferentiated Liposarcoma, Presenting Two Radiologically and Pathologically Distinctive Patterns

Manabu Hoshi1, Seiichi Matsumoto1, Jun Manabe1, Taisuke Tanizawa1, Toshio Shigemitsu1, Hirotaka Koyanagi1, Keisuke Ae1, Kengo Takeuchi2 and Noriyoshi Kawaguchi1

1 Department of Orthopaedic Oncology and 2 Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

For reprints and all correspondence: Seiichi Matsumoto, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo 135-8550, Japan. E-mail: smatsumoto{at}jfcr.or.jp

Received November 21, 2005; accepted April 1, 2006

In this paper, we report three cases with dedifferentiated liposarcoma in the lower extremities, presenting two patterns that are distinctively different radiologically and pathologically. The first case was a 67-year-old male who had discovered a mass in his left thigh, which was shown as a low and iso density mass between the muscles on computed tomography (CT). The second case was a 61-year-old male who had suffered from an intramuscular tumor with a non-fatty sarcomatous area within the fatty components as shown on magenetic resonance imaging (MRI). The third case was a 52-year-old female who had presented with an intramuscular tumor of the left thigh, consisting of a mass with fat and another soft tissue tumor adjacent to the lipomatous component as detected with CT and MRI. The final pathological diagnoses of the resected specimens in all three cases were concluded to be dedifferentiated liposarcoma, composed of well-differentiated liposarcomas and spindle and/or pleomorphic sarcomas, compatible with malignant fibrous histiocytoma. In all three cases, wide resection of the tumor was successfully carried out, and all patients have been continuously disease-free up to the most recent follow-up. Evaluation of the surgical margins for the resected specimens indicated that the safety margin for a dedifferentiated lesion should be accomplished as an adequate margin or more, and a marginal margin or more could be considered as safe only for the confined part of a well-differentiated liposarcoma.

Key Words: two distinctive patterns • dedifferentiated liposarcoma • surgical margin


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