Pleural dedifferentiated liposarcoma: A case report

Matsukuma,Susumu; Oshika,Yoshiro; Utsumi,Yoshitaka; Obara,Kiyohaya; Tanimoto,Takao; Katsurada,Yuka; Takeo,Hiroaki

doi:10.3892/mco.2018.1757

Pleural dedifferentiated liposarcoma: A case report

Authors:
- Susumu Matsukuma
- Yoshiro Oshika
- Yoshitaka Utsumi
- Kiyohaya Obara
- Takao Tanimoto
- Yuka Katsurada
- Hiroaki Takeo
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Affiliations: Department of Pathology, Japan Self‑Defense Forces Central Hospital, Tokyo 154‑8532, Japan, Division of Thoracic Surgery, Japan Self‑Defense Forces Central Hospital, Tokyo 154‑8532, Japan, Division of Respiratory Medicine, Japan Self‑Defense Forces Central Hospital, Tokyo 154‑8532, Japan
Published online on: November 5, 2018 https://doi.org/10.3892/mco.2018.1757
Pages: 132-136

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Abstract

The present case report describes a rare case of pleural liposarcoma. A 45‑year‑old Japanese man was hospitalized for increasing left chest pain. Imaging revealed a 10‑cm pleural tumor and a 1.7‑cm contralateral right pulmonary nodule. Biopsy specimens of the pleural tumor showed undifferentiated spindle‑shaped and/or rounded sarcomatous features with myxoid stroma. The patient underwent embolization of the arteries feeding the left pleural tumor and palliative partial resection of the pleural tumor. The surgically removed specimens exhibited similar undifferentiated sarcomatous features. The left pleural tumor regrew aggressively, and the patient succumbed to mortality ~4.2 months following hospitalization. Autopsy demonstrated a 35‑cm left pleural tumor, metastasizing to both adrenal glands and lumbar vertebral bones, and a 2.2‑cm primary adenocarcinoma of the right lung. The majority of the left pleural tumor and its metastases consisted of undifferentiated sarcomatous elements, however, scattered or aggregated lipoblasts were identified in localized areas adjacent to the diaphragm. Immunohistochemically, these lipoblasts were diffusely positive for MDM2 and focally positive for S‑100 protein. Undifferentiated sarcomatous tumor cells were focally positive for MDM2 but negative for S‑100 protein. This case was diagnosed as pleural dedifferentiated liposarcoma. The local aggressiveness of the pleural liposarcoma directly contributed to the patient's mortality. A review of the literature indicated that the dedifferentiated subtype may serve as a factor that is indicative of a poor prognosis for pleural liposarcoma.

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