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Mannelli G, Bassani S, Cosi G, Fermi M, Gazzini L, Liberale C, Mazzetti L, Parrinello G, Saibene AM, Molteni G, Comini LV. Global frequency and distribution of head and neck sarcomas in adulthood: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:2553-2567. [PMID: 38381151 DOI: 10.1007/s00405-024-08477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE Head and neck sarcomas (HNS) constitute a rare and heterogeneous cancer entity. Management remains a challenge due their rarity and different biological behaviour among tens of subtypes. This systematic review aimed to describe HNS global frequency and distribution in adulthood. METHODS A systematic review was performed using PICOTS search strategies for qualitative question and it was written in accordance with PRISMA 2020 Statement. 70,653 publications were identified, and 15 variables were evaluated for a total of 2428 patients. RESULTS We identified 47 studies from 21 different countries from 5 different continents. Most of studies (83.3%) were performed in single institutions and America and Asia overruled for number of papers included (21 and 10, respectivelly). Osteosarcoma was more frequent, followed by chondrosarcoma, angiosarcoma and malignant fibrous histiocytoma. Early stage accounted for almost 80% of cases; advanced stage prevailed in developing countries. 1783 patients (90.1%) underwent surgery and 780 (39.4%) had adjuvant therapy. 50.8% of patients experienced tumour recurrence and the lowest mortality rate was reported in Europe (29.9%). CONCLUSIONS HNS holds a relative poor prognosis possibly explained by the heterogeneity of the disease. Treatment of HNS has shown to be highly diverse among different countries, underlining the importance of uniformed treatment guidelines to achieve better patient management and to improve survival outcomes.
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Affiliation(s)
- Giuditta Mannelli
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sara Bassani
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Ginevra Cosi
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Matteo Fermi
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Luca Gazzini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Carlotta Liberale
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Luca Mazzetti
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giampiero Parrinello
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otolaryngology-Head and Neck Surgery, IRCCS San Martino Polyclinc Hospital, Genoa, Italy
| | - Alberto Maria Saibene
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology Department, Department of Health Sciences, Santi Paolo e Carlo Hospital, Università Degli Studi di Milano, Milan, Italy
| | - Gabriele Molteni
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Lara Valentina Comini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria.
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142-KM 3.95, 10060, Candiolo, TO, Italy.
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Tsavdaridou I, Pink D, Aristeidou A. Head and neck soft tissue sarcomas fighting for their own identity: A case report of a retropharyngeal liposarcoma and a literature review of case reports of retropharyngeal liposarcomas. OTOLARYNGOLOGY CASE REPORTS 2023. [DOI: 10.1016/j.xocr.2023.100532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kuang Y, Liang L, Li X, Li T. A case of liposarcoma with osteolysis of the maxilla as the first symptom and review of the literature. Oral Oncol 2023; 139:106340. [PMID: 36821984 DOI: 10.1016/j.oraloncology.2023.106340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
Liposarcomas are extremely rare in the oral cavity and mainly observed in the buccal mucosa, tongue, floor of the mouth, gingiva, and lips, while those occurring in the jaws have not been reported so far. Clinically, the initial presentation of liposarcoma is usually a painless soft tissue mass. The aim of this study was to report a case of liposarcoma with osteolysis of the maxilla as the first symptom, and review the relevant literature to summarize its clinical features, imaging features, pathological features and treatment methods.
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Affiliation(s)
- Yishen Kuang
- The Department of Stomatology of The Fifth Affiliated Hospital, Sun Yat-Sen University, Guangdong, Zhuhai 519000, China
| | - Lizhong Liang
- The Department of Stomatology of The Fifth Affiliated Hospital, Sun Yat-Sen University, Guangdong, Zhuhai 519000, China
| | - Xiangwei Li
- The Department of Stomatology of The Fifth Affiliated Hospital, Sun Yat-Sen University, Guangdong, Zhuhai 519000, China
| | - Tong Li
- The Department of Stomatology of The Fifth Affiliated Hospital, Sun Yat-Sen University, Guangdong, Zhuhai 519000, China.
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Kugimoto T, Yamagata Y, Ohsako T, Hirai H, Nishii N, Kayamori K, Ikeda T, Harada H. Massive low-grade myxoid liposarcoma of the floor of the mouth: A case report and review of literature. World J Clin Cases 2022; 10:12742-12749. [PMID: 36579093 PMCID: PMC9791511 DOI: 10.12998/wjcc.v10.i34.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course. Here, we report a case of massive low-grade myxoid liposarcoma (MLS) of the floor of the mouth.
CASE SUMMARY A 71-year-old man presented with a huge mass in the left floor of the mouth. A biopsy was performed, and a diagnosis of a myxoid tumor suspicious for low-grade MLS or myxoma was made. Gadolinium-enhanced T1-weighted magnetic resonance imaging showed an intensely enhanced tumor lesion that occupies the left sublingual space and extends to the submandibular space. Submandibular dissection, tumor resection, and reconstruction with a radial forearm flap were performed. The surgical specimen exhibited histologically low-grade MLS. Fused in sarcoma (FUS, also known as TLS) and DNA damage-inducible transcript 3 (DDIT3, also known as CHOP) break-apart was not detected in the fluorescence in situ hybridization analysis. The tumor was completely encapsulated and did not require additional treatment. Furthermore, no recurrence was reported 40 mo after surgery.
CONCLUSION We experienced an extremely rare, massive, low-grade MLS emerging from the floor of the mouth. Oftentimes, an MLS of the floor of the mouth lacks significant clinical findings and is often misdiagnosed. Although no FUS-DDIT3 fusion gene was detected, a low-grade MLS was ultimately diagnosed based on the histological findings.
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Affiliation(s)
- Takuma Kugimoto
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Yuko Yamagata
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Toshimitsu Ohsako
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Hideaki Hirai
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Naoto Nishii
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Kou Kayamori
- Department of Oral Pathology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Tohru Ikeda
- Department of Oral Pathology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan
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Gerard M, Flaris AN, Demarchi M, El Boukili I, Maillard L, Borson-Chazot F, Decaussin-Petrucci M, Lifante JC. Thyroid liposarcoma: a case report. Innov Surg Sci 2022; 7:133-137. [PMID: 36561504 PMCID: PMC9742268 DOI: 10.1515/iss-2021-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 07/25/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives Thyroid liposarcoma is a rare tumor. Its low prevalence accounts for the scarcity of data in the literature, which consists mostly of small studies and case reports. Case presentation We present the case of a 60 years old male with no past medical or past surgical history and presented with neck discomfort and a large left thyroid nodule. Thyroid ultrasound and CT scan were performed and confirmed the existence of a thyroid nodule most probably inside the left inferior thyroid lobe. In the posterior mediastinum, two fatty formations were found. To complete, an MRI was performed, showing a mixed lesion, of the lower neck and upper chest. The patient underwent an extended resection which consisted of an en bloc resection of the lesion (left thyroid lobectomy and isthmus resection) by an anterior transverse cervical incision and a sternotomy. Tracheal and laryngeal shaving and esophageal shaving with resection of the esophageal muscularis was performed as well. The pathological evaluation of the specimen showed a grade II dedifferentiated liposarcoma with an inflammatory component. Conclusions Thyroid liposarcoma is a rare lesion of the thyroid. Its management requires an exhaustive workup followed by an en bloc resection of the lesion. Depending on the histology, postoperative radiation therapy may or may not be necessary.
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Affiliation(s)
- Maxime Gerard
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France
| | - Alexander N. Flaris
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France,Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Marco Demarchi
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France
| | - Ilies El Boukili
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France
| | - Laure Maillard
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France
| | - Françoise Borson-Chazot
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France,RESHAPE Research on Healthcare Performance, INSERM U1290-UCBL 1, Domaine Rockefeller, 8 Avenue Rockefeller, Lyon, France
| | | | - Jean-christophe Lifante
- Service de chirurgie endocrinienne, Hôpital Lyon Sud, Pierre Bénite, France,RESHAPE Research on Healthcare Performance, INSERM U1290-UCBL 1, Domaine Rockefeller, 8 Avenue Rockefeller, Lyon, France
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6
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Kotecha S, Williams MA, White HB, Graystone J, Gibbons M, Cosker T. Head and neck sarcoma: three-year data from a tertiary referral centre. Ann R Coll Surg Engl 2021; 103:762-767. [PMID: 34448646 DOI: 10.1308/rcsann.2021.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Sarcomas of the head and neck are neoplasms arising from the embryonic mesenchyme. They are rare and heterogeneous in nature and are associated with significant morbidity and mortality. This study evaluates patients referred to the Oxford Sarcoma Service, a tertiary referral centre. METHODS Patients discussed over a three-year period were included. Medical records were analysed using the electronic patient record database. Data were acquired on a range of domains, including: demographics, histopathology, treatment modality, recurrence, mortality, survival, etc. RESULTS Thirty-two eligible patients, 21 male and 11 female, were identified with a mean age of 58 years; 26 out of 32 patients had high-grade sarcomas. The commonest histological subtype was chondrosarcoma (8/32). Twenty-two underwent planned multidisciplinary team surgical resection after biopsy and staging: negative margins were noted in 9, with close and involved margins in 5 and 8, respectively. Local recurrence was noted in 13 and 6 had metastatic disease out of the 32 eligible patients. Mortality was noted in 10 out of 32 patients. Mean survival was 69.5 months. Five-year overall survival was 64%. Surgery demonstrated statistically significant improvement in survival (p=0.0095). There were no significant differences in survival, recurrence or marginal status between methods of adjuvant or neoadjuvant therapy. CONCLUSION Outcomes of head and neck sarcomas are inferior compared with other types of sarcoma. The nature of the complex surrounding anatomy presents unique challenges in surgical management. This in turn affects rates of local recurrence and prognosis. Therefore, it is critical that they are managed in tertiary, specialist centres with a multidisciplinary approach.
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Affiliation(s)
- S Kotecha
- Oxford University Hospitals NHS Foundation Trust, UK
| | - M A Williams
- Oxford University Hospitals NHS Foundation Trust, UK
| | | | - J Graystone
- Oxford University Hospitals NHS Foundation Trust, UK
| | - M Gibbons
- Oxford University Hospitals NHS Foundation Trust, UK
| | - T Cosker
- Oxford University Hospitals NHS Foundation Trust, UK
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Kim YC, Ryu S, Won SJ, Park JJ. Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma Arising from the Tongue: case report. KOSIN MEDICAL JOURNAL 2020. [DOI: 10.7180/kmj.2020.35.1.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
<p>Liposarcomas are common mesenchymal malignant tumors arising from adipose tissue. Although liposarcomas are the most frequent type of soft tissue sarcomas, accounting for approximately 20% of all soft tissue sarcomas, they are rare in the head and neck, particularly in the oral cavity. Oral liposarcomas have been reported to occur mainly on the buccal mucosa, with other sites including the floor of the mouth, tongue, palate, and mandible. This report describes a 76-year-old male patient with an atypical lipomatous tumor/well-differentiated liposarcoma of the tongue that underwent surgical excision. This report also reviews published data on these rare tumors.
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8
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Transoral robotic resection of a posterior hypopharyngeal wall liposarcoma: A case report of a rare entity and literature review. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2020.100158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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9
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Tran NA, Guenette JP, Jagannathan J. Soft Tissue Special Issue: Imaging of Bone and Soft Tissue Sarcomas in the Head and Neck. Head Neck Pathol 2020; 14:132-143. [PMID: 31950470 PMCID: PMC7021877 DOI: 10.1007/s12105-019-01102-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/16/2019] [Indexed: 12/14/2022]
Abstract
Bone and soft tissue sarcomas of the head and neck are a heterogenous group of tumors with overlapping features. Distinguishing between the various subtypes is challenging but necessary for appropriate diagnosis and management. The purpose of this article is to discuss the role of imaging in evaluating head and neck tumors, provide a general radiographic approach in differentiating between benign versus malignant lesions and give examples of selected subtypes of bone and soft tissue sarcomas in the head and neck with classic or pathognomonic imaging findings.
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Affiliation(s)
- Ngoc-Anh Tran
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Jeffrey P Guenette
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Jyothi Jagannathan
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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Abstract
RATIONALE Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign lesion because of its asymptomatic and indolent clinical course. we report a case of atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) of buccal mucosa, provisionally diagnosed as lipoma. PATIENT CONCERNS A 97-year-old female was referred to dentistry and oral surgery department with an asymptomatic mass on the right buccal mucosa which had been present for an unknown period of time. DIAGNOSIS Magnetic resonance imaging demonstrated a well-circumscribed lesion at the right buccal mucosa, and a lipoma was suspected. INTERVENTIONS Surgical removal was performed, and a diagnosis of ALT/WDL was made. She and her family refused additional treatment due to her age. OUTCOMES At the 10 months follow-up, the patient remained free of disease. LESSONS The indolent clinical course and small size of oral liposarcoma can lead to provisional clinical diagnosis of benign lesion.
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Affiliation(s)
- Keiichi Ohta
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences
| | - Hitoshi Yoshimura
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences
| | - Shinpei Matsuda
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences
| | - Yoshiaki Imamura
- Division of Surgical Pathology, University of Fukui Hospital, Fukui, Japan
| | - Kazuo Sano
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences
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Kishimoto Y, Kishimoto AO, Yamada Y, Kitano M, Kitada Y, Kitamura M, Tateya I, Sonobe M, Omori K. Dedifferentiated liposarcoma of the thyroid gland: A case report. Mol Clin Oncol 2019; 11:219-224. [PMID: 31384458 PMCID: PMC6636207 DOI: 10.3892/mco.2019.1882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 04/05/2019] [Indexed: 12/21/2022] Open
Abstract
Liposarcoma is one of the most common soft tissue tumors that affect adults. Liposarcoma is typically identified in the retroperitoneum, trunk and extremities as a slow-growing mass, yet is rare in the thyroid gland. Herein, we report a case of dedifferentiated liposarcoma that developed in the thyroid gland, and performed a literature review. A 66-year-old male with a history of well-differentiated liposarcoma in the thymus presented with a rapidly enlarging mass in the thyroid gland. Malignancy was suspected due to the local extension of the tumor, and complete resection of the tumor was achieved. Tissue diagnosis from the tumor following surgery revealed that dedifferentiated liposarcoma, and tumor progression was difficult to control with adjuvant radiation and chemotherapy. This is, to the best of our knowledge, the first case to report dedifferentiated liposarcoma in the thyroid gland, and the difficulty in initial diagnosis as well as the aggressive features of dedifferentiated liposarcoma are highlighted.
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Affiliation(s)
- Yo Kishimoto
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Ayami Ohno Kishimoto
- Department of Diagnosic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Yosuke Yamada
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Masayuki Kitano
- Department of Otolaryngology-Head and Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka 543-8555, Japan
| | - Yuji Kitada
- Department of Otolaryngology-Head and Neck Surgery, Kitano Hospital Tazuke Medical Research Institute, Osaka 530-8480, Japan
| | - Morimasa Kitamura
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Ichiro Tateya
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Makoto Sonobe
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
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Košec A, Zurak K, Čupić H, Bedeković V. Primary parotid liposarcoma. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:405-408. [PMID: 30876853 DOI: 10.1016/j.anorl.2018.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 12/05/2017] [Accepted: 01/05/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Primary liposarcoma is very rare in the parotid gland. To date, only 8 cases of primary parotid liposarcoma have been reported. The aim of this study is to report on a case of primary parotid liposarcoma highlighting the complexity of its treatment and analyze treatment outcomes of other reported cases. CASE SUMMARY We report a case of parotid liposarcoma arising in the left parotid gland of a 66 year-old man, causing local morbidity, recurrence, repeated surgical treatment and death 5 months after initial treatment. DISCUSSION Parotid liposarcoma is marked by a high probability of local recurrence of up to 70% and is prone to distant metastatic spread, as was the case in our patient. Based on limited experience from published literature, optimal treatment entails radical surgery with negative margins. Postoperative radiotherapy is an option for patients with large high-grade tumors, positive margins and involvement of complex anatomic subsites. High-grade tumors have a worse outcome despite the addition of surgery and postoperative radiotherapy.
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Affiliation(s)
- A Košec
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Vinogradska cesta 29, Zagreb, Croatia.
| | - K Zurak
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Vinogradska cesta 29, Zagreb, Croatia
| | - H Čupić
- Department of Pathology Ljudevit Jurak, University Hospital Center Sestre milosrdnice, Vinogradska cesta 29, Zagreb, Croatia
| | - V Bedeković
- School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia
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Andrea T, Giulio G, Giuliana L, Sandro P. Primary dedifferentiated liposarcoma of the orbit, a rare entity: Case report and review of literature. Saudi J Ophthalmol 2019; 33:312-315. [PMID: 31686978 PMCID: PMC6819729 DOI: 10.1016/j.sjopt.2019.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/09/2019] [Indexed: 12/26/2022] Open
Abstract
Head and neck liposarcomas are rare entities accounting for less than 5% of all liposarcomas. The primary orbital location is even rarer, with about 40 cases described in the English literature. According with the widely accepted classification of Enzinger and Weis there are 5 histologic variants of liposarcomas: well differentiated, myxoid, dedifferentiated, round cell and pleomorphic. The first two are considered low-grade and display a favourable prognosis (>90% 5-year DSS and OS), whereas the dedifferentiated, round cell, and pleomorphic are defined high-grade and burdened with poorer prognosis (5-year DSS ranging 45-73%). Dedifferentiated liposarcomas (DDL) of the head and neck region are exceedingly rare, therefore there are scattered and contrasting data regarding their clinical history, treatment modality, and prognosis. We presented a case of DDL arising in the the left orbit (fourth case of primary orbital DDL described), free from disease after 5-year follow-up. Clinical history, treatment, and characteristics of the presented case were described and discussed in the light of how reported in the literature, in the attempt to bring further insight in the nature and management of this rare pathological entity.
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Affiliation(s)
- Torroni Andrea
- Department of Plastic Surgery, Division of Oral and Maxillofacial Surgery, New York University, USA
| | - Gasparini Giulio
- Department of Maxillofacial Surgery, Catholic University of the Sacred Hearth of Rome, Italy
| | - Longo Giuliana
- Department of Maxillofacial Surgery, Catholic University of the Sacred Hearth of Rome, Italy
| | - Pelo Sandro
- Department of Maxillofacial Surgery, Catholic University of the Sacred Hearth of Rome, Italy
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Kram YA, McCann JM, Golden J, Wirtz E. A rare cause of dysphagia: Pyriform sinus atypical lipomatous tumor. EAR, NOSE & THROAT JOURNAL 2018; 97:114-115. [PMID: 29940678 DOI: 10.1177/0145561318097004-507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yoseph A Kram
- Department of Otolaryngology, Tripler Army Medical Center, Hawaii, USA
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15
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Guarda V, Pickhard A, Boxberg M, Specht K, Buchberger AMS. Liposarcoma of the Thyroid: A Case Report with a Review of the Literature. Eur Thyroid J 2018; 7:102-108. [PMID: 29594062 PMCID: PMC5869545 DOI: 10.1159/000486333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/14/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Liposarcomas of the thyroid gland are extremely rare tumors, and, to our knowledge, only 12 cases have been reported in the English literature. An accurate diagnosis is challenging due to the nonspecific clinical presentation of this cancer, frequently defined just by a swelling of the neck. PATIENT FINDINGS We present an 82-year-old woman with liposarcoma of the thyroid, complaining of a fast-growing neck mass. MRI and neck ultrasound showed a large lipomatous mass, which corresponded to a cold nodule in the thyroid scan. After performing a total thyroidectomy, the diagnosis of a well-differentiated liposarcoma of the thyroid gland was made, showing an MDM2 amplification in fluorescence in situ hybridization. Since neither a metastasis nor a residual tumor was found, no further adjuvant therapy was needed. RESULTS We searched the literature for previous case reports and identified only 12 cases worldwide to form our database. A demographic as well as clinical and histopathological analysis was made. In most cases, the liposarcoma occurred in patients >60 years of age. All histological subtypes, such as well-differentiated and myxoid liposarcomas, and pleomorphic and dedifferentiated liposarcomas, were found in the literature. In only 38.46% of the cases, an infiltration of the adjacent organs was observed. Surgery was the most common treatment chosen. CONCLUSIONS Our review provides clinical and histopathological features of a primary liposarcoma of the thyroid to enable the identifi-cation of this rare tumor entity and assist in the decision-making process regarding therapeutic options and tumor follow-up.
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Affiliation(s)
- Vittoria Guarda
- Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany
- *Vittoria Guarda, Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Ismaninger Strasse 22, DE-81675 Munich (Germany), E-Mail
| | - Anja Pickhard
- Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany
| | - Melanie Boxberg
- Institute of Pathology, Technical University of Munich, Munich, Germany
| | - Katja Specht
- Institute of Pathology, Technical University of Munich, Munich, Germany
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16
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Makary RF, Gopinath A, Markiewicz MR, Fernandes R. Margin Analysis. Oral Maxillofac Surg Clin North Am 2017; 29:355-366. [DOI: 10.1016/j.coms.2017.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Pleomorphic liposarcoma of the head and neck: Presentation of two cases and literature review. Am J Otolaryngol 2017; 38:505-507. [PMID: 28528729 DOI: 10.1016/j.amjoto.2017.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 04/09/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pleomorphic liposarcoma (PL) is an exceedingly rare tumor of the head and neck. This aggressive liposarcoma variant portends a poorer prognosis compared to more typical sarcomatous tumors. METHODS Multi-institutional study including two cases of PL, the first case occurring in the post-auricular region and the second in the cheek with later recurrence within the parotid bed. RESULTS Both patients were treated surgically with wide local excision. One patient required reoperation to obtain negative margins. The other patient underwent a total parotidectomy with neck dissection for recurrent intraparotid nodal disease. Both patients underwent adjuvant radiotherapy. No patient had evidence of recurrent disease with minimum one year follow-up. CONCLUSION Although the literature is sparse on this disease, wide surgical extirpation with negative margins and adjuvant radiation is recommended. Increased reports of this pathology can be helpful in providing practitioners with experienced-based information that can aid in early detection and treatment. We present the first case series of PL of the head and neck in the literature.
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18
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Tudor-Green B, Gomez R, Brennan PA. Current update on the diagnosis and management of head and neck soft tissue sarcomas. J Oral Pathol Med 2017; 46:674-679. [PMID: 28140483 DOI: 10.1111/jop.12555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 01/19/2023]
Abstract
Head and neck soft tissue sarcomas are a group of rare heterogeneous tumours arising from embryonic mesoderm. They comprise <1% of all head and neck malignancies and 5-15% of all sarcomas with most head and neck sarcomas arising from soft tissues. Although rare, they are associated with both high recurrence and mortality rates. We review the current management of head and neck soft tissue sarcomas.
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Affiliation(s)
- Ben Tudor-Green
- Department of Plastic & Reconstructive Surgery, Royal Devon & Exeter Hospital, Exeter, UK.,Department of Oral & Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| | - Ricardo Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Peter A Brennan
- Department of Oral & Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
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Abstract
INTRODUCTION Myxoid liposarcoma is the only translocation-associated liposarcoma subtype. It classically originates in the deep soft tissues of the thigh. At distal sites of the extremities, this tumor is exceedingly rare. We present a series of 8 cases occurring in the foot/ankle. RESULTS Two female and 6 male patients, aged between 32 and 77 years (mean, 54.3 years), were identified. Tumor size ranged from 1.1 to 10 cm (mean, 6.8 cm). Two lesions eroded bone. All tumors were treated by excision and 7 by (neo)adjuvant radiotherapy. R0 status was reached in 2 cases with 1 case followed by metastasis in the groin. All other cases were documented with R1 (n=2) or R2 (n=4) resection status. In 1 patient, the follow-up status was unknown. All other patients were alive 15-135 (mean, 55.8) months after initial diagnosis. We conclude that myxoid liposarcoma at acral sites are exceedingly rare, and in this series, prognosis was good irrespective of resection status. Clinicians and pathologists have to be aware because this sarcoma type shows a peculiar clinical behavior with high radio- and chemosensitivity and metastatic spread to extrapulmonary sites.
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20
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Nili F, Baghai F, Aghai A, Etebarian A. Well-differentiated liposarcoma of the floor of the mouth: Report of a rare case and review of the literature. J Oral Maxillofac Pathol 2016; 20:312-5. [PMID: 27601829 PMCID: PMC4989567 DOI: 10.4103/0973-029x.185984] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Liposarcomas are extremely rare in the oral cavity. Less than 100 cases of oral liposarcoma have been reported in the world wide literature, mostly occurring in the buccal mucosa, whereas only <10 cases have been reported in the floor of the mouth. We present a rare case of oral liposarcoma that occurred in the floor of the mouth of a 45-year-old female patient. She had a history of two previous recurrences and underwent surgical excision with 24 months of follow-up. Clinical as well as histopathological features and therapeutic approaches of liposarcomas are discussed here, and a literature review is presented. Intraoral liposarcomas have a high rate of local recurrences but generally favorable prognosis based on the histopathologic subtype, location and clear surgical margins. Conservative surgical therapy without adjuvant chemoradiotherapy is recommended, due to the rarity of distant metastasis.
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Affiliation(s)
- Fatemeh Nili
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Fereshteh Baghai
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Aghai
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Etebarian
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
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21
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Kodiyan J, Rudman JR, Rosow DE, Thomas GR. Lipoma and liposarcoma of the larynx: case reports and literature review. Am J Otolaryngol 2015; 36:611-5. [PMID: 25841535 DOI: 10.1016/j.amjoto.2014.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/02/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Two cases of laryngeal lipomatous tumors are presented. Their diagnoses and management are discussed and contrasted. METHODS Case report and literature review. RESULTS Patient 1 is a 58 year old male presenting with five years of progressive shortness of breath, dysphagia, and globus sensation. Clinical exam and imaging study showed a 3.5 cm hypodense laryngeal mass, and he underwent transoral robotic-assisted surgery for complete excision. Final pathology revealed a well-differentiated liposarcoma. Patient 2 is a 79 year old female presenting with one year of non-progressive hoarseness and globus sensation. Clinical examination and imaging study revealed a 1.8 cm hypodense laryngeal mass. Transoral endoscopic complete excision of the submucosal mass was performed. Final pathology revealed benign spindle-cell lipoma. CONCLUSION Liposarcoma and lipoma may present with similar symptomatology, clinical, and imaging findings. Pathology evaluation is of utmost importance for definitive diagnosis. Therefore, diagnosis and treatment of laryngeal lipomatous lesions are best accomplished with complete excision of the mass.
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Affiliation(s)
- Joyson Kodiyan
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA.
| | - Jason R Rudman
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA
| | - David E Rosow
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA
| | - Giovana R Thomas
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA
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22
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Zreik R, Soyalp K, Ruiz S, Ward R, Dobin S, Chen X, Liu L, Rao A. Ultrasound-guided fine-needle aspiration of a posterior neck dedifferentiated liposarcoma with MDM2 fluorescence in situ hybridization performed on a Pap-stained smear. Diagn Cytopathol 2014; 43:320-4. [PMID: 25132684 DOI: 10.1002/dc.23200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 07/17/2014] [Indexed: 01/07/2023]
Abstract
Head and neck liposarcomas, while rare, tend to be subcutaneous and well-differentiated. Dedifferentiated liposarcomas of the head and neck are exceedingly rare in the literature. We present a case of a dedifferentiated liposarcoma arising in the soft tissue of the posterior neck of an 86-year-old man and diagnosed by fine-needle aspiration. Aspirate smears showed a dual population of atypical lipomatous and spindled cells. MDM2 (murine double minute 2) amplification was demonstrated on a Pap-stained smear using fluorescence in situ hybridization (FISH). To the best of our knowledge, this is the first report of MDM2 FISH amplification in a liposarcoma performed on an aspirate smear.
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Affiliation(s)
- Riyam Zreik
- Department of Pathology, Baylor Scott & White and Texas A&M, Temple, Texas
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23
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de Bree E, Karatzanis A, Hunt JL, Strojan P, Rinaldo A, Takes RP, Ferlito A, de Bree R. Lipomatous tumours of the head and neck: a spectrum of biological behaviour. Eur Arch Otorhinolaryngol 2014; 272:1061-77. [DOI: 10.1007/s00405-014-3065-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/15/2014] [Indexed: 12/13/2022]
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24
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Shin J, Kim YC. Conglomerated facial liposarcoma. Ann Dermatol 2013; 25:245-7. [PMID: 23717022 PMCID: PMC3662924 DOI: 10.5021/ad.2013.25.2.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 07/17/2012] [Accepted: 07/25/2012] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jaeyoung Shin
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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25
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O'Neill JP, Bilsky MH, Kraus D. Head and neck sarcomas: epidemiology, pathology, and management. Neurosurg Clin N Am 2013; 24:67-78. [PMID: 23174358 DOI: 10.1016/j.nec.2012.08.010] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Sarcomas of the head, neck, and skull base represent a heterogeneous group of tumors with distinct prognostic features. There have been significant improvements in characterizing these sarcomas using traditional morphologic assessments and more recent immunohistochemical analysis. Surgery is the mainstay of treatment followed by radiation therapy. Treatment modalities have changed in select pediatric sarcomas, for which new chemotherapeutic combinations have improved survival statistics. The high rate of distant failure emphasizes the need for novel systemic and directed molecular therapies. Tumor grade, size, and margin status are key factors in survival.
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Affiliation(s)
- James Paul O'Neill
- Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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26
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Affiliation(s)
- S Mikolajczak
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Uniklinik Köln, Kerpener Str. 62, 59824, Köln, Deutschland.
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27
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Oysu C, Uslu C, Naiboglu B, Ogredik EA. Myxoid/round cell liposarcoma of the supraclavicular fossa. EAR, NOSE & THROAT JOURNAL 2012; 91:77-9. [PMID: 22359136 DOI: 10.1177/014556131209100212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Metastases from the tracheobronchial tree and the genitourinary and gastrointestinal systems are the most common malignant lesions of the supraclavicular fossa. Liposarcomas in this region, as primary tumors, are rarely encountered. In this article, we report a case of myxoid liposarcoma of the supraclavicular fossa with a fulminant course.
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Affiliation(s)
- Cagatay Oysu
- Department of Otolaryngology, Umraniye Research and Education Hospital, Istanbul, Turkey.
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28
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Cheng J, Yu H, Wang L, Wang X, Shen G. Primary oral and maxillofacial liposarcoma: a clinicopathological and immunohistochemical study of eleven cases. Arch Med Sci 2012; 8:316-23. [PMID: 22662006 PMCID: PMC3361045 DOI: 10.5114/aoms.2012.28560] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 12/28/2010] [Accepted: 01/22/2011] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The present study was aimed to characterize the clinicopathological, immunohistochemical features and treatment outcomes of primary oral and maxillofacial liposarcomas by presenting the experience over a 16-year period at a tertiary referral Chinese institution for head neck cancer. MATERIAL AND METHODS This retrospective clinical study included 11 cases of pathologically confirmed primary liposarcomas treated from January 1993 to September 2009. Detailed information regarding primary site, clinical manifestations, histopathological and immunohistochemical analysis, treatments and prognosis was collected and reported. RESULTS Eight female and 3 male patients aged from 8 to 76 years old. These lesions occurred in buccal (3), parotid (2), temporal (2), tongue (2), palate (1) and oropharyngeal (1) region. They were histopathologically categorized into 4 subtypes based on WHO classification scheme: atypical lipomatous tumor/well-differentiated (4), myxoid (4), mixed-type (2) and pleomorphic (1) liposarcomas. Immunohistochemical staining indicated mostly positive for Vimentin and S-100 but negative for other markers. Most patients presented as slow-growing painless masses and underwent surgery alone or combined with postoperative radiotherapy. Two patients were misdiagnosed and inappropriate treated and developed local relapse before referred to our institute. No distant metastasis and one disease-related death were recorded during the follow-up (ranging: 1-11 years, mean: 4.5 years). CONCLUSIONS Oral and maxillofacial liposarcoma is exceedingly rare and has atypical clinical manifestations but characteristic histopathology. Complete excision with negative margins followed by long-term follow-up is recommended as the treatment of choice for these uncommon entities.
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Affiliation(s)
- Jie Cheng
- Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China
| | - Hongbo Yu
- Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Lizhen Wang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xudong Wang
- Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Guofang Shen
- Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
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Blumberg JM, Jedrych J, Costa J, Judson B. Cervical dedifferentiated liposarcoma with meningothelial-like whorling. Head Neck Pathol 2012; 6:476-80. [PMID: 22528826 PMCID: PMC3500890 DOI: 10.1007/s12105-012-0354-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 04/01/2012] [Indexed: 02/03/2023]
Abstract
Liposarcomas are the most common soft-tissue sarcoma of adults, but rare in the head and neck. Recently, a subtype of dedifferentiated liposarcoma with meningiothelial-like whorls was reported and we present the first description of such a tumor in the head and neck. A 65 year old male underwent a resection of a calcified retroesophageal mass that was in close relation to the left hemithyroid and recurrent laryngeal nerve. It was resected en bloc with the left thyroid lobe. Initial pathologic evaluation suggested the mass was a schwanomma of the recurrent laryngeal nerve, but positive staining for MDM2 and CDK4 indicated the tumor was a dedifferentiated liposarcoma. Further evaluation elucidated the unique meningothelial-like whorls within the tumor. This case demonstrates dedifferentiated liposarcomas do appear in the head and neck. Furthermore, this is the first report in the head and neck of the mengiothelial-like whorling pattern type of dedifferentiated liposarcoma.
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Affiliation(s)
- Jeffrey M. Blumberg
- Yale Otolaryngology, Yale Physicians Building, 800 Howard Avenue, 4th floor, New Haven, CT 06519 USA
| | - Jaroslaw Jedrych
- Department of Pathology, Yale University School of Medicine, P.O. Box 208023, 310 Cedar Street, LH 108, New Haven, CT 06520-8023 USA
| | - Jose Costa
- Department of Pathology, Yale University School of Medicine, P.O. Box 208023, 310 Cedar Street, LH 108, New Haven, CT 06520-8023 USA
| | - Benjamin Judson
- Yale Otolaryngology, Yale Physicians Building, 800 Howard Avenue, 4th floor, New Haven, CT 06519 USA
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30
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Liposarcoma of the nasopharynx: diagnosis and management of a rare diagnostic entity. Case Rep Med 2012; 2012:314697. [PMID: 22489241 PMCID: PMC3318223 DOI: 10.1155/2012/314697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 01/11/2012] [Accepted: 01/20/2012] [Indexed: 02/07/2023] Open
Abstract
Liposarcoma is one of the most frequently occurring soft tissue sarcomas in adulthood. The majority of liposarcomas arise in the lower extremities and retroperitoneum, while the incidence of this tumor in the head and neck region is reported to be extremely low, comprising 1.8%–6.2% of all cases. Nasopharyngeal liposarcoma is exceptionally rare, with only three cases having been reported in the English literature. This paper presents a case of a nasopharyngeal liposarcoma, treated with endoscopic tumor debulking, followed by adjuvant chemotherapy and radiotherapy, and reviews the current literature with regard to diagnosis and management of such lesions. Most authors agree that the imaging modality of choice is magnetic resonance imaging. Although radiographic findings usually support diagnosis, the imaging characteristics of such lesions may considerably vary, depending on the histological subtype and the macroscopic appearance of the tumor. The treatment of choice is complete surgical excision when possible. Although the role of postoperative radiotherapy is not clearly defined, some authors support that radiotherapy might delay or prevent local recurrence. However, there is no adequate evidence that the combination of surgery and radiotherapy lowers the possibility of distant metastasis of the head and neck liposarcomas. The role of adjuvant or neoadjuvant chemotherapy still remains controversial.
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Well-differentiated liposarcoma/atypical lipomatous tumor of the oral cavity: report of three cases and review of the literature. Head Neck Pathol 2012; 6:354-63. [PMID: 22234501 PMCID: PMC3422587 DOI: 10.1007/s12105-011-0327-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 12/27/2011] [Indexed: 12/11/2022]
Abstract
Atypical Lipomatous Tumor/Well Differentiated Liposarcoma (ALT/WDLS) is a soft tissue sarcoma of intermediate malignant behavior, most frequently affecting the retroperitoneum and lower extremities. Oral liposarcomas are very rare neoplasms, the most common histological subtype being ALT/WDLS. In this study, three additional cases of ALT/WDLS located on the tongue (2 cases) and the lower lip (1 case), respectively, are described. Analysis of the salient clinicopathologic features of 63 oral ALT/WDLS cases previously reported in the English language literature, as well as of the 3 cases presented in this study, indicates that the indolent biologic behavior of this tumor justifies its designation as a locally spreading malignant neoplasm, affording a rather conservative surgical approach.
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Stomeo F, Bianchini C, Ciorba A, Padovani D, Pedriali M, Pelucchi S, Pastore A. Giant dedifferentiated liposarcoma of the right hemifacial area involving the oral cavity. Gerodontology 2011; 29:e1152-6. [DOI: 10.1111/j.1741-2358.2011.00455.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Eley KA, Shah KA, Watt-Smith SR. A slowly enlarging cheek mass. ACTA ACUST UNITED AC 2011; 111:269-74. [PMID: 21310352 DOI: 10.1016/j.tripleo.2010.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 11/24/2010] [Accepted: 11/29/2010] [Indexed: 11/15/2022]
Affiliation(s)
- Karen A Eley
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK.
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35
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Ohta N, Watanabe T, Abe Y, Onoe Y, Ishida A, Aoyagi M. Differentiated posterior cervical liposarcoma with carcinoid: report of a case. Auris Nasus Larynx 2010; 38:421-5. [PMID: 21035290 DOI: 10.1016/j.anl.2010.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 09/24/2010] [Accepted: 09/30/2010] [Indexed: 11/26/2022]
Abstract
Liposarcoma most commonly arises in the retroperitoneum and lower extremities. Liposarcoma of the head and neck region is a rare and potentially life-threatening malignancy. Those originating in the right retrocervical space cause special diagnostic and therapeutic difficulties. In present report, a case of differentiated liposarcoma of the right cervical region with intestinal carcinoid is reported. The tumor continued to grow slowly over 3 years before a definitive diagnosis was established. Extended extirpation of the tumor and modified radical neck dissection, postoperative radiotherapy followed by chemotherapy were performed and proved to be efficacious in that no recurrence was observed for 2 years. Recommendations for earlier and correct diagnosis and treatment of this rare neoplasm are discussed.
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Affiliation(s)
- Nobuo Ohta
- Department of Otolaryngology, Yamagata University, School of Medicine, 2-2-2 Iida-nishi, Yamagata, Japan.
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36
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de Bree R, van der Waal I, de Bree E, Leemans CR. Management of adult soft tissue sarcomas of the head and neck. Oral Oncol 2010; 46:786-90. [PMID: 20947413 DOI: 10.1016/j.oraloncology.2010.09.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 09/02/2010] [Accepted: 09/03/2010] [Indexed: 12/25/2022]
Abstract
Adult soft tissue sarcoma of the head and neck are rare and represent a heterogeneous group of tumours of different histological variants. Management of these neoplasms presents a great challenge. Malignant fibrous histiocytoma, fibrosarcoma, angiosarcoma and malignant peripheral nerve sheath tumour are the most frequently found sarcoma types in the head and neck. Although traditional morphological assessment is the foundation of clinical decision making, the role of immunohistochemistry and molecular biology are useful for diagnosis, prognosis and identification of possible targets for molecular therapy. The most frequently involved tumour sites are scalp/face, sinonasal tract/anterior skull base and parotid/neck. The management of soft tissue sarcomas in the head and neck is primarily surgical. Since it is difficult to obtain wide margins during surgical treatment in head and neck sarcomas, because of anatomic constraints, most patients undergo post-operative irradiation. Survival varies from 50 to 80%. Prognostic factors are tumour grade, margin status and tumour size. With further insight into the biology of soft tissue sarcoma, modern imaging techniques and new treatment options, we will most certainly be able to improve clinical outcome in patients with soft tissue sarcoma in the upcoming years.
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Affiliation(s)
- Remco de Bree
- Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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37
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Gleinser DM, Font JP, Clement CG, Mohammed BS, Underbrink MP. Primary myxoid liposarcoma of the supraglottic larynx. Rare Tumors 2010; 2:e41. [PMID: 21139957 PMCID: PMC2994524 DOI: 10.4081/rt.2010.e41] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Revised: 05/13/2010] [Accepted: 05/18/2010] [Indexed: 11/25/2022] Open
Abstract
Sarcomas are a rare occurrence accounting for roughly 1% of all cancer cases reported. Of these, 9–18% will be identified as liposarcoma. Overall, only 4–9% of all liposarcomas occur in the head and neck region. As such, it is a rare event to see a primary liposarcoma of the aerodigestive tract. These tumors are typically misdiagnosed secondary to their indolent, asymptomatic course and similarities in appearance to other benign lesions. An understanding of these lesions will help clinicians appropriately manage their patients. We present a case of a 60-year male with a primary supraglottic myxoid liposarcoma, and provide relevant information about liposarcomas.
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Affiliation(s)
- David M Gleinser
- University of Texas Medical Branch, Department of Otolaryngology, Galveston, TX, USA
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Gritli S, Khamassi K, Lachkhem A, Touati S, Chorfa A, Ben Makhlouf T, El May A, Gammoudi A. Head and neck liposarcomas. Auris Nasus Larynx 2010; 37:347-51. [DOI: 10.1016/j.anl.2009.08.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 06/01/2009] [Accepted: 08/02/2009] [Indexed: 12/11/2022]
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Laryngeal dedifferentiated liposarcoma. Eur Arch Otorhinolaryngol 2010; 267:991-4. [PMID: 20383516 DOI: 10.1007/s00405-010-1234-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 03/05/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Soft tissue liposarcomas are quite common in the adult population, whereas liposarcoma of the larynx is exceedingly rare. METHODS We describe an exceptional case of liposarcoma of the posterior aspect of the left arytenoid in a 62-year-old woman who was treated with two endoscopic excisions and adjuvant radiotherapy (RT). This is the 32nd case of laryngeal liposarcoma reported in the English literature. RESULTS After a 20 months follow-up, no local, regional recurrences or distant metastases were detected, and no functional complications are described for the patient. CONCLUSION This case report highlights that endoscopic surgical treatment enables excellent organ and functional preservation. However, recurrence of laryngeal liposarcoma is the principal risk, so extended follow-up is essential. RT has no defined role in treatment but can be discussed, especially considering the surgical margins and recurrence status.
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:134-45. [PMID: 20234215 DOI: 10.1097/moo.0b013e3283383ef9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mumert ML, Walsh MT, Jensen EM, Jensen RL. Pleomorphic liposarcoma originating from intracranial dura mater. J Neurooncol 2009; 97:149-53. [PMID: 19727564 DOI: 10.1007/s11060-009-0005-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Accepted: 08/16/2009] [Indexed: 11/25/2022]
Abstract
Liposarcomas are the most common soft tissue sarcoma found in adults; however, disease involving or spreading to the head and neck is extremely rare. To our knowledge, we present the first case of primary pleomorphic liposarcoma originating intracranially. A 56-year-old man presented with new weakness and imaging findings confirming a right frontal mass. After resection, histological analysis confirmed the diagnosis of pleomorphic liposarcoma. The patient underwent radiation treatment and surveillance imaging, which revealed no other areas of disease. Results reported previously in the literature indicate that pleomorphic liposarcoma is very aggressive in nature. The authors review the few cases of primary or metastatic pleomorphic liposarcoma that have been reported involving the head.
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Affiliation(s)
- Michael L Mumert
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
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