Primary endobronchial liposarcoma successfully resected via bronchoscopy: A rare case report with genetic analysis

Liu,Yuanshun; Jiang,Hua; Xu,Qiuran; Zhou,Hongbin; Li,Yaqing

doi:10.3892/ol.2018.8737

Primary endobronchial liposarcoma successfully resected via bronchoscopy: A rare case report with genetic analysis

Authors:
- Yuanshun Liu
- Hua Jiang
- Qiuran Xu
- Hongbin Zhou
- Yaqing Li
View Affiliations

Affiliations: Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China, Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
Published online on: May 18, 2018 https://doi.org/10.3892/ol.2018.8737
Pages: 843-848
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Liposarcoma is the most common type of soft‑tissue sarcoma, and predominantly originates from the extremities and retroperitoneal cavity. However, primary endobronchial liposarcoma is extremely rare. The present study reports on the case of a 54‑year‑old man, a smoker, diagnosed with primary endobronchial atypical lipomatous tumor/well‑differentiated liposarcoma (ALT‑WDLS), which was successfully resected via bronchoscopy. Chest computed tomography (CT) revealed a neoplasm in the left main bronchus measuring 12.8x7.8 mm. Bronchoscopy demonstrated multiple roundish, pedunculated, polypoid masses in the left main bronchus. Bioptic specimens were obtained from the roundish masses, and pathological examination revealed an adipose tissue‑derived tumor. The masses were completely resected during the second bronchoscopy under general anesthesia. Histopathological examination of the radical resection specimen revealed that it was an ALT‑WDLS. The patient showed good quality of life at the 6‑month postoperative follow‑up without evidence of recurrence. Immunohistochemistry was completed with the human homologue of murine double‑minute type 2 (MDM2) (+), cyclin‑dependent kinase 4 (CDK4) (+), p16 (+), S‑100 (+), Ki‑67 (+), cluster of differentiation 34 (CD34) (+) and retinoblastoma protein (+), confirming ALT‑WDLS. However, the fluorescence in situ hybridization assay revealed no amplification of MDM2 and CDK4 in the ALT‑WDLS. To the best of our knowledge, the present case report is the first to describe the clinicopathologic features and genetic analysis of endobronchial liposarcoma. Although rare, this case is a reminder that clinicians should consider the possibility of this rare endobronchial tumor in patients with nonspecific symptoms including chronic cough, chest pain and recurrent pneumonia. As in this case, endoscopic treatment provided an excellent clinical outcome in patients with primary endobronchial ALT‑WDLS.

View Figures

View References

1	Ducimetière F, Lurkin A, Ranchère-Vince D, Decouvelaere AV, Péoc'h M, Istier L, Chalabreysse P, Muller C, Alberti L, Bringuier PP, et al: Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One. 6:e202942011. View Article : Google Scholar : PubMed/NCBI
2	Fletcher CDM, Bridge JA, Hogendoorn P and Mertens F: WHO classification of tumours of soft tissue and bone. 4th edition. IARC Press; Lyon: 2013
3	Kashu Y, Yukumi S, Tsunooka N, Tanigawa K, Arakane M, Nakagawa H and Kawachi K: Successful resection of a massive mediastinal liposarcoma that rapidly extended into the entire left thoracic cavity: Report of a case. Surg Today. 42:68–71. 2012. View Article : Google Scholar : PubMed/NCBI
4	Stevic R and Milenkovic B: Tracheobronchial tumors. J Thorac Dis. 8:3401–3413. 2016. View Article : Google Scholar : PubMed/NCBI
5	Macchiarini P: Primary tracheal tumours. Lancet Oncol. 7:83–91. 2006. View Article : Google Scholar : PubMed/NCBI
6	Weaver J, Downs-Kelly E, Goldblum JR, Turner S, Kulkarni S, Tubbs RR, Rubin BP and Skacel M: Fluorescence in situ hybridization for MDM2 gene amplification as a diagnostic tool in lipomatous neoplasms. Mod Pathol. 21:943–949. 2008. View Article : Google Scholar : PubMed/NCBI
7	Dei Tos AP, Doglioni C, Piccinin S, Sciot R, Furlanetto A, Boiocchi M, Dal Cin P, Maestro R, Fletcher CD and Tallini G: Coordinated expression and amplification of the MDM2, CDK4, and HMGI-C genes in atypical lipomatous tumours. J Pathol. 190:531–536. 2000. View Article : Google Scholar : PubMed/NCBI
8	Singer S, Socci ND, Ambrosini G, Sambol E, Decarolis P, Wu Y, O'Connor R, Maki R, Viale A, Sander C, et al: Gene expression profiling of liposarcoma identifies distinct biological types/subtypes and potential therapeutic targets in well-differentiated and dedifferentiated liposarcoma. Cancer Res. 67:6626–6636. 2007. View Article : Google Scholar : PubMed/NCBI
9	Kollar A and Benson C: Current management options for liposarcoma and challenges for the future. Expert Rev Anticancer Ther. 14:297–306. 2014. View Article : Google Scholar : PubMed/NCBI
10	Nassif NA, Tseng W, Borges C, Chen P and Eisenberg B: Recent advances in the management of liposarcoma. F1000Res. 5:29072016. View Article : Google Scholar : PubMed/NCBI
11	Spinelli P, Pizzetti P, Lo Gullo C, Rocca F, Gobbi A and Ravasi G: Resection of obstructive bronchial fibrolipoma through the flexible fiberoptic bronchoscope. Endoscopy. 14:61–63. 1982. View Article : Google Scholar : PubMed/NCBI
12	Patel RB, Li T, Liao Z, Jaldeepbhai JA, Perera HAPNV, Muthukuda SK, Dhirubhai DH, Singh V, Du X and Yang J: Recent translational research into targeted therapy for liposarcoma. Stem Cell Investig. 4:212017. View Article : Google Scholar : PubMed/NCBI
13	Laurino L, Furlanetto A, Orvieto E and Dei Tos AP: Well-differentiated liposarcoma (atypical lipomatous tumors). Semin Diagn Pathol. 18:258–262. 2001.PubMed/NCBI
14	Kammerer-Jacquet SF, Thierry S, Cabillic F, Lannes M, Burtin F, Henno S, Dugay F, Bouzillé G, Rioux-Leclercq N, Belaud-Rotureau MA and Stock N: Differential diagnosis of atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma: utility of p16 in combination with MDM2 and CDK4 immunohistochemistry. Hum Pathol. 59:34–40. 2017. View Article : Google Scholar : PubMed/NCBI
15	Vargas DA, Takahashi S and Ronai Z: Mdm2: A regulator of cell growth and death. Adv Cancer Res. 89:1–34. 2003. View Article : Google Scholar : PubMed/NCBI
16	Oliner JD, Kinzler KW, Meltzer PS, George DL and Vogelstein B: Amplification of a gene encoding a p53-associated protein in human sarcomas. Nature. 358:80–83. 1992. View Article : Google Scholar : PubMed/NCBI
17	Oliner JD, Pietenpol JA, Thiagalingam S, Gyuris J, Kinzler KW and Vogelstein B: Oncoprotein MDM2 conceals the activation domain of tumour suppressor p53. Nature. 362:857–860. 1993. View Article : Google Scholar : PubMed/NCBI
18	Kato J, Matsushime H, Hiebert SW, Ewen ME and Sherr CJ: Direct binding of cyclin D to the retinoblastoma gene product (pRb) and pRb phosphorylation by the cyclin D-dependent kinase CDK4. Genes Dev. 7:331–342. 1993. View Article : Google Scholar : PubMed/NCBI
19	Weinberg RA: The retinoblastoma protein and cell cycle control. Cell. 81:323–330. 1995. View Article : Google Scholar : PubMed/NCBI
20	Fåhraeus R, Paramio JM, Ball KL, Lain S and Lane DP: Inhibition of pRb phosphorylation and cell-cycle progression by a 20-residue peptide derived from p16CDKN2/INK4A. Curr Biol. 6:84–91. 1996. View Article : Google Scholar : PubMed/NCBI
21	He M, Aisner S, Benevenia J, Patterson F, Aviv H and Hameed M: p16 immunohistochemistry as an alternative marker to distinguish atypical lipomatous tumor from deep-seated lipoma. Appl Immunohistochem Mol Morphol. 17:51–56. 2009. View Article : Google Scholar : PubMed/NCBI
22	Thway K, Flora R, Shah C, Olmos D and Fisher C: Diagnostic utility of p16, CDK4, and MDM2 as an immunohistochemical panel in distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors. Am J Surg Pathol. 36:462–469. 2012. View Article : Google Scholar : PubMed/NCBI
23	Pilotti S, Della Torre G, Mezzelani A, Tamborini E, Azzarelli A, Sozzi G and Pierotti MA: The expression of MDM2/CDK4 gene product in the differential diagnosis of well differentiated liposarcoma and large deep-seated lipoma. Br J Cancer. 82:1271–1275. 2000. View Article : Google Scholar : PubMed/NCBI
24	Binh MB, Sastre-Garau X, Guillou L, de Pinieux G, Terrier P, Lagacé R, Aurias A, Hostein I and Coindre JM: MDM2 and CDK4 immunostainings are useful adjuncts in diagnosing well-differentiated and dedifferentiated liposarcoma subtypes: A comparative analysis of 559 soft tissue neoplasms with genetic data. Am J Surg Pathol. 29:1340–1347. 2005. View Article : Google Scholar : PubMed/NCBI
25	Coindre JM, Mariani O, Chibon F, Mairal A, De Saint Aubain Somerhausen N, Favre-Guillevin E, Bui NB, Stoeckle E, Hostein I and Aurias A: Most malignant fibrous histiocytomas developed in the retroperitoneum are dedifferentiated liposarcomas: A review of 25 cases initially diagnosed as malignant fibrous histiocytoma. Mod Pathol. 16:256–262. 2003. View Article : Google Scholar : PubMed/NCBI
26	Creytens D, van Gorp J, Ferdinande L, Van Roy N and Libbrecht L: Array-based comparative genomic hybridization analysis of a pleomorphic myxoid liposarcoma. J Clin Pathol. 67:834–835. 2014. View Article : Google Scholar : PubMed/NCBI