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Liu DN, Yan L, Li ZW, Wang HY, Tian XY, Lv A, Hao CY. Optimizing surgical strategies for retroperitoneal liposarcoma: a comprehensive evaluation of standardized aggressive surgical policies. BMC Cancer 2024; 24:855. [PMID: 39026264 PMCID: PMC11256468 DOI: 10.1186/s12885-024-12629-4] [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: 02/16/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Retroperitoneal liposarcoma (RLPS) constitutes the majority of retroperitoneal sarcomas. While surgical resection remains the sole curative approach, determining the optimal surgical strategy for RLPS remains elusive. This study addresses the ongoing debate surrounding the optimal surgical strategy for RLPS. METHODS We recruited 77 patients with RLPS who underwent aggressive surgical policies. Patients were categorized into three surgical subtypes: suprapancreatic RLPS, pancreatic RLPS, and subpancreatic RLPS. Our standardized surgical strategy involved resecting macroscopically uninvolved adjacent organs according to surgical subtypes. We collected clinical, pathological and prognostic data for analyses. RESULTS The median follow-up was 45.5 months. Overall survival (OS) and recurrence-free survival (RFS) were significantly correlated with multifocal RLPS, pathological subtype, recurrent RLPS and histological grade (P for OS = 0.011, 0.004, 0.010, and < 0.001, P for RFS = 0.004, 0.001, < 0.001, and < 0.001, respectively). The 5-Year Estimate OS of well-differentiated liposarcoma (WDLPS), G1 RLPS, de novo RLPS and unifocal RLPS were 100%, 89.4%, 75.3% and 69.1%, respectively. The distant metastasis rate was 1.4%. The morbidity rates (≥ grade III) for suprapancreatic, pancreatic, and subpancreatic RLPS were 26.7%, 15.6%, and 13.3%, respectively. The perioperative mortality rate is 2.6%. CONCLUSIONS Standardized aggressive surgical policies demonstrated prognostic benefits for RLPS, particularly for G1 RLPS, WDLPS, unifocal RLPS, and de novo RLPS. This approach effectively balanced considerations of adequate exposure, surgical safety, and thorough removal of all fat tissue. G1 RLPS, WDLPS, unifocal RLPS, and de novo RLPS could be potential indications for aggressive surgical policies.
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Affiliation(s)
- Dao-Ning Liu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Liang Yan
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Zhong-Wu Li
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Hai-Yue Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Xiu-Yun Tian
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Ang Lv
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Chun-Yi Hao
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China.
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Wang M, Li Z, Zeng S, Wang Z, Ying Y, He W, Zhang Z, Wang H, Xu C. Explainable machine learning predicts survival of retroperitoneal liposarcoma: A study based on the SEER database and external validation in China. Cancer Med 2024; 13:e7324. [PMID: 38847519 PMCID: PMC11157677 DOI: 10.1002/cam4.7324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/15/2024] [Accepted: 05/12/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE We have developed explainable machine learning models to predict the overall survival (OS) of retroperitoneal liposarcoma (RLPS) patients. This approach aims to enhance the explainability and transparency of our modeling results. METHODS We collected clinicopathological information of RLPS patients from The Surveillance, Epidemiology, and End Results (SEER) database and allocated them into training and validation sets with a 7:3 ratio. Simultaneously, we obtained an external validation cohort from The First Affiliated Hospital of Naval Medical University (Shanghai, China). We performed LASSO regression and multivariate Cox proportional hazards analysis to identify relevant risk factors, which were then combined to develop six machine learning (ML) models: Cox proportional hazards model (Coxph), random survival forest (RSF), ranger, gradient boosting with component-wise linear models (GBM), decision trees, and boosting trees. The predictive performance of these ML models was evaluated using the concordance index (C-index), the integrated cumulative/dynamic area under the curve (AUC), and the integrated Brier score, as well as the Cox-Snell residual plot. We also used time-dependent variable importance, analysis of partial dependence survival plots, and the generation of aggregated survival SHapley Additive exPlanations (SurvSHAP) plots to provide a global explanation of the optimal model. Additionally, SurvSHAP (t) and survival local interpretable model-agnostic explanations (SurvLIME) plots were used to provide a local explanation of the optimal model. RESULTS The final ML models are consisted of six factors: patient's age, gender, marital status, surgical history, as well as tumor's histopathological classification, histological grade, and SEER stage. Our prognostic model exhibits significant discriminative ability, particularly with the ranger model performing optimally. In the training set, validation set, and external validation set, the AUC for 1, 3, and 5 year OS are all above 0.83, and the integrated Brier scores are consistently below 0.15. The explainability analysis of the ranger model also indicates that histological grade, histopathological classification, and age are the most influential factors in predicting OS. CONCLUSIONS The ranger ML prognostic model exhibits optimal performance and can be utilized to predict the OS of RLPS patients, offering valuable and crucial references for clinical physicians to make informed decisions in advance.
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Affiliation(s)
- Maoyu Wang
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Zhizhou Li
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Shuxiong Zeng
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Ziwei Wang
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Yidie Ying
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Wei He
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Zhensheng Zhang
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Huiqing Wang
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
| | - Chuanliang Xu
- Department of UrologyShanghai Changhai Hospital, Naval Medical UniversityShanghaiChina
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Liu DN, Wu JH, Li ZW, Wang HY, Tian XY, Hao CY. Preoperative assessment of retroperitoneal Liposarcoma using volume-based 18F-FDG PET/CT: implications for surgical strategy and prognosis. BMC Med Imaging 2023; 23:215. [PMID: 38110909 PMCID: PMC10726537 DOI: 10.1186/s12880-023-01179-z] [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: 10/07/2023] [Accepted: 12/11/2023] [Indexed: 12/20/2023] Open
Abstract
PURPOSE Retroperitoneal liposarcoma (RLPS) poses a challenging scenario for surgeons due to its unpredictable biological behavior. Surgery remains the primary curative option for RLPS; however, the need for additional information to guide surgical strategies persists. Volume-based 18F-FDG PET/CT may solve this issue. METHODS We analyzed data from 89 RLPS patients, measuring metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) and explored their associations with clinical, prognostic, and pathological factors. RESULTS MTV, TLG of multifocal and recurrent RLPS were significantly higher than unifocal and primary ones (P < 0.001, P < 0.001, P = 0.003 and P = 0.002, respectively). SUVmax correlated with FNCLCC histological grade, mitotic count and Ki-67 index (P for G1/G2 = 0.005, P for G2/G3 = 0.017, and P for G1/G3 = 0.001, P < 0.001 and P = 0.024, respectively). MTG, TLG and SUVmax of WDLPS were significantly lower than DDLPS and PLPS (P for MTV were 0.009 and 0.022, P for TLG were 0.028 and 0.048, and P for SUVmax were 0.027 and < 0.001, respectively). Multivariable Cox analysis showed that MTV > 457.65 (P = 0.025), pathological subtype (P = 0.049) and FNCLCC histological grade (P = 0.033) were related to overall survival (OS). CONCLUSIONS Our findings indicate that MTV is an independent prognostic factor for RLPS, while MTV, TLG, and SUVmax can preoperatively predict multifocal lesions, histological grade, and pathological subtype. Volume-based 18F-FDG PET/CT offers valuable information to aid in the decision-making process for RLPS surgical strategies.
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Affiliation(s)
- Dao-Ning Liu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Jian-Hui Wu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Zhong-Wu Li
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Hai-Yue Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Xiu-Yun Tian
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China
| | - Chun-Yi Hao
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery/Sarcoma center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China.
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Vlăsceanu VI, Soroceanu RP, Timofte DV, Iordache AG, Strobescu CC, Timofeiov S. Retroperitoneal liposarcoma: unveiling diagnostic delays and multimodal treatment dilemmas. Arch Clin Cases 2023; 10:187-190. [PMID: 38098695 PMCID: PMC10719986 DOI: 10.22551/2023.41.1004.10272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Liposarcomas are a prevalent subtype of soft tissue sarcomas, constituting less than 1% of all malignancies. Originating in the adipose tissue, they can manifest in various locations and are categorized by the World Health Organization into several subtypes: well-differentiated liposarcomas, dedifferentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and mixed-type liposarcomas. These tumors typically affect middle-aged and older individuals, and their incidence has been progressively increasing over the years. As liposarcomas advance they tend to encase blood vessels and major organs, particularly in the retroperitoneal area. Often asymptomatic initially, symptoms arise as the tumor reaches a considerable size, exerting pressure on adjacent tissues and organs. This report features a 54-year-old patient incidentally diagnosed with a substantial retroperitoneal tumor extending to the antero-lateral abdominal wall and inner thigh via the right inguinal ligament. The patient, with a previous three-year history of a right inguinal mass, sought acute care for a perianal abscess The histological examination revealed morphological aspects consistent with a low-grade myxoid liposarcoma. While surgery remains the primary treatment for retroperitoneal liposarcomas, controversies exist regarding the role of radiotherapy and chemotherapy in improving survival rates. This case highlights the challenges in managing retroperitoneal tumors and underscores the importance of a personalized, multidisciplinary approach to optimize patient outcomes.
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Affiliation(s)
- Vlad Ionuţ Vlăsceanu
- 3 Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
| | - Radu Petru Soroceanu
- 3 Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
- Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Daniel Vasile Timofte
- 3 Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
- Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Andi Gabriel Iordache
- 3 Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
| | - Cristina Ciobanu Strobescu
- 3 Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
- Vascular Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
| | - Sergiu Timofeiov
- 3 Surgical Unit, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iaşi, Romania
- Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
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5
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Selby LV, Clark EC, Liebner DA, Chen JL, Tinoco G, Bashian E, Beane JD, Pollock RE, Grignol VP. Adjuvant Palbociclib May be Associated with Delayed Recurrence in Completely Resected Retroperitoneal Liposarcoma: Results of a Single-Institution Retrospective Cohort Study. Ann Surg Oncol 2023; 30:7876-7881. [PMID: 37330448 DOI: 10.1245/s10434-023-13692-0] [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: 01/10/2022] [Accepted: 05/19/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Retroperitoneal liposarcomas are locally aggressive and frequently recur following complete surgical resection. Palbociclib, a cyclin-dependent kinase (CDK) 4/CDK6 inhibitor, is effective in the treatment of metastatic or unresectable liposarcoma. OBJECTIVE The purpose of this study was to describe our initial experience using adjuvant palbociclib to delay recurrence. METHODS Patients with resected RPS were identified from a prospectively maintained institutional database. In 2017, we began offering adjuvant palbociclib to patients following complete gross resection. Treatment interval, defined as the time between surgical resection and re-resection or change in systemic therapy, was compared between patients selected for adjuvant palbociclib or observation. RESULTS Between 2017 and 2020, 12 patients underwent a total of 14 operations (14 patient cases) and were selected for adjuvant palbociclib for recurrence prevention. These patients were compared with 14 patients who, since 2010, underwent a total of 20 operations (20 patient cases) and were selected for observation. Histology was primarily dedifferentiated liposarcoma for both groups (observation: 70% [14/20]; adjuvant palbociclib: 64% [9/14]). All patients underwent complete gross resection. Neither age, number of previous surgeries, histologic grade, or Eastern Cooperative Oncology Group (ECOG) performance status differed between groups (p > 0.05 for all). Patients selected for adjuvant palbociclib experienced a longer treatment interval than those selected for observation, although it did not reach statistical significance (20.5 months vs. 13.1 months, p = 0.08, log rank). CONCLUSION Adjuvant palbociclib may be associated with a prolonged interval between liposarcoma resection and the need for re-resection or other systemic therapy. Palbociclib may be effective in delaying liposarcoma recurrence, and its use for this indication warrants prospective study.
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Affiliation(s)
- Luke V Selby
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Division of Colorectal and Oncologic Surgery, Department of Surgery, University of Kansas Medical Center, Kansas City, KS, USA
| | - Emma C Clark
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - David A Liebner
- Division of Medical Oncology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - James L Chen
- Division of Medical Oncology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Gabriel Tinoco
- Division of Medical Oncology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Elizabeth Bashian
- The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Joal D Beane
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Raphael E Pollock
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Valerie P Grignol
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Kassi ABF, Yenon KS, Kassi FMH, Adjeme AJ, Diarra KM, Bombet-Kouame C, Kouassi M. Giant dedifferentiated liposarcoma of the gastrocolic ligament: A case report. World J Gastrointest Surg 2023; 15:2376-2381. [PMID: 37969706 PMCID: PMC10642459 DOI: 10.4240/wjgs.v15.i10.2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Dedifferentiated liposarcoma (DDLS) has a worse prognosis and occurs most commonly in the retroperitoneal region and rarely in the intraperitoneal region. Histological diagnosis was revolutionized by the combined contributions of histo-immuno-chemistry and molecular biology. Aside from surgery, there is no consensus on the optimal treatment for this chemoresistant cancer. CASE SUMMARY A thirty-year-old black female presented with a large painful abdominal mass occupying nearly the entire abdomen and progressive weight loss was admitted for surgery. Abdominal computed tomography showed a large heterogeneous mass of the mesentery that was sized 18 cm × 16 cm in size and had heterogeneous contrast enhancement. During laparotomy, en bloc excision of the large and multilobulated gastrocolic ligament mass was performed. The initial postoperative histopathological diagnosis was undifferentiated sarcoma. Finally, the results of immunohistochemistry and molecular biology allowed us to confirm the diagnosis of DDLS. The tumour followed an aggressive evolution with diffuse metastasis, causing the death of the patient less than 5 mo after the operation. CONCLUSION Dedifferentiated liposarcomas are rare tumours that typically originate in the retroperitoneum but may arise in unexpected locations.
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Affiliation(s)
- Assamoi Brou Fulgence Kassi
- Surgery and Surgical Specialities, Medical Sciences Training and Research Unit, Abidjan Felix Houphouet-Boigny University, Abidjan 01 BP V 34, Cote d'Ivoire
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Kacou Sebastien Yenon
- Surgery and Surgical Specialities, Medical Sciences Training and Research Unit, Abidjan Felix Houphouet-Boigny University, Abidjan 01 BP V 34, Cote d'Ivoire
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Fian Marc Herve Kassi
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Adja Jacob Adjeme
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Khader Morel Diarra
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Cynthia Bombet-Kouame
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Marcellin Kouassi
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
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Resag A, Toffanin G, Benešová I, Müller L, Potkrajcic V, Ozaniak A, Lischke R, Bartunkova J, Rosato A, Jöhrens K, Eckert F, Strizova Z, Schmitz M. The Immune Contexture of Liposarcoma and Its Clinical Implications. Cancers (Basel) 2022; 14:cancers14194578. [PMID: 36230502 PMCID: PMC9559230 DOI: 10.3390/cancers14194578] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Liposarcomas (LPS) are the most frequent malignancies in the soft tissue sarcoma family and consist of five distinctive histological subtypes, termed well-differentiated LPS, dedifferentiated LPS (DDLPS), myxoid LPS (MLPS), pleomorphic LPS, and myxoid pleomorphic LPS. They display variations in genetic alterations, clinical behavior, and prognostic course. While accumulating evidence implicates a crucial role of the tumor immune contexture in shaping the response to anticancer treatments, the immunological landscape of LPS is highly variable across different subtypes. Thus, DDLPS is characterized by a higher abundance of infiltrating T cells, yet the opposite was reported for MLPS. Interestingly, a recent study indicated that the frequency of pre-existing T cells in soft tissue sarcomas has a predictive value for immune checkpoint inhibitor (CPI) therapy. Additionally, B cells and tertiary lymphoid structures were identified as potential biomarkers for the clinical outcome of LPS patients and response to CPI therapy. Furthermore, it was demonstrated that macrophages, predominantly of M2 polarization, are frequently associated with poor prognosis. An improved understanding of the complex LPS immune contexture enables the design and refinement of novel immunotherapeutic approaches. Here, we summarize recent studies focusing on the clinicopathological, genetic, and immunological determinants of LPS.
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Affiliation(s)
- Antonia Resag
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Giulia Toffanin
- Department of Surgery Oncology and Gastroenterology, University of Padova, Via Gattamelata 64, 35128 Padova, Italy
| | - Iva Benešová
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Immunology, Second Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Luise Müller
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Vlatko Potkrajcic
- Department of Radiation Oncology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany
| | - Andrej Ozaniak
- Third Department of Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Robert Lischke
- Third Department of Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Jirina Bartunkova
- Department of Immunology, Second Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Antonio Rosato
- Department of Surgery Oncology and Gastroenterology, University of Padova, Via Gattamelata 64, 35128 Padova, Italy
- Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy
| | - Korinna Jöhrens
- Institute of Pathology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307 Dresden, Germany
- National Center for Tumor Diseases (NCT), University Hospital Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Franziska Eckert
- Department of Radiation Oncology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany
- Department of Radiation Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Zuzana Strizova
- Department of Immunology, Second Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague, Czech Republic
- Correspondence: (Z.S.); (M.S.); Tel.: +420-604712471 (Z.S.); +49-351-458-6501 (M.S.)
| | - Marc Schmitz
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- National Center for Tumor Diseases (NCT), University Hospital Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Correspondence: (Z.S.); (M.S.); Tel.: +420-604712471 (Z.S.); +49-351-458-6501 (M.S.)
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8
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Yee EJ, Stewart CL, Clay MR, McCarter MM. Lipoma and Its Doppelganger: The Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma. Surg Clin North Am 2022; 102:637-656. [PMID: 35952693 DOI: 10.1016/j.suc.2022.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Lipomatous tumors are among the most common soft tissue lesions encountered by the general surgeon. Shared history and clinical presentation make differentiation between benign lipomas and low-grade liposarcomas a diagnostic dilemma. This article reviews the epidemiology, clinical history, diagnostic workup, management, natural history, and surveillance of benign lipomas and atypical lipomatous tumors/well-differentiated liposarcomas. Although it is important that aggressive, potentially malignant atypical lipomatous tumors and liposarcomas be managed in a multidisciplinary, preferably high-volume setting, it is equally as important for the nonspecialist general surgeon to be familiar with lipoma and its doppelganger-the well-differentiated liposarcoma.
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Affiliation(s)
- Elliott J Yee
- Department of Surgery, University of Colorado, 12605 East 16th Avenue, Aurora, CO 80045, USA.
| | - Camille L Stewart
- Department of Surgery, University of Colorado, 12605 East 16th Avenue, Aurora, CO 80045, USA
| | - Michael R Clay
- Department of Pathology, Univeristy of Colorado, 12605 East 16th Avenue, Aurora, CO 80045, USA
| | - Martin M McCarter
- Department of Surgery, University of Colorado, 12605 East 16th Avenue, Aurora, CO 80045, USA
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9
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Giant retroperitoneal liposarcoma: A case report. Int J Surg Case Rep 2022; 97:107465. [PMID: 35917605 PMCID: PMC9403284 DOI: 10.1016/j.ijscr.2022.107465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Retroperitoneal liposarcomas are rare malignancy. They can grow usually asymptomatic until large enough to compress the surrounding organ. Giant retroperitoneal liposarcoma with diameter over 30 cm and weight over 20 kg is extremely rare. There has been limited report of giant retroperitoneal liposarcoma. CASE PRESENTATION A 34-year old woman complained about intermittent abdominal discomfort and progressive abdominal distension for last 2 years. There was history of weight loss for last 3 months. CT scan with contrast showed giant right abdominal mass that expanded to the pelvis (30.4 × 28 × 34 × 29 cm), oppressed surrounding organs and displaced the intestine to the left side with no visualization of normal right kidney structure. Complete resection of this retroperitoneal tumor was performed without combined resection of the surrounding organ. The biopsy of tumor showed a well differentiated liposarcoma. We diagnosed this patient with giant retroperitoneal liposarcoma. The postoperative course was uneventful and the patient was discharged on the 3th postoperative day. Last follow up, 3 months after surgical resection, patient had no complaints and there was no recurrence of this retroperitoneal liposarcoma. CLINICAL DISCUSSION Complete resection is the predominant treatment of retroperitoneal liposarcoma to avoid recurrence. Successful complete resection of retroperitoneal liposarcoma may increase the 5-year survival rate from 16.7 to 58 %. However, complete resection is a challenge, particularly in the well-differentiated subtype, for the reason that the margins are not easily distinguishable. CONCLUSION Giant retroperitoneal liposarcoma is an extremely rare tumor with high rate of recurrence, depends on some factors such as the histological type and grade, the metastasis, and also completeness of tumor resection. In this case we performed complete resection without combined resection of the surrounding organ. Furthermore, we will continue to observe our patient closely for recurrence.
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Wei X, Qin Y, Ouyang S, Qian J, Tu S, Yao J. Challenging surgical treatment of giant retroperitoneal liposarcoma: A case report. Oncol Lett 2022; 24:314. [PMID: 35949617 PMCID: PMC9353788 DOI: 10.3892/ol.2022.13434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022] Open
Abstract
Liposarcoma is a rare malignant tumor type and surgical resection is the gold standard treatment. The present study reported on the case of a 51-year-old woman who presented with a mass in the left upper abdomen. Computed tomography revealed a 32-cm giant retroperitoneal liposarcoma. Complete tumor resection was performed without the removal of other organs. Postoperative pathological examination indicated retroperitoneal well-differentiated liposarcoma and immunohistochemistry revealed S-100(−), MDM2(+), vimentin(+), CDK4(+), p16(+) and STAT6(+) results. The patient recovered well after the surgery. Complete tumor resection during the first surgery is key to cure liposarcoma. The present case report will be helpful for clinical oncologists to fully understand giant retroperitoneal liposarcoma and treat it accordingly.
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Affiliation(s)
- Xiaoyi Wei
- Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China
| | - Yujie Qin
- Endoscopy Center, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China
| | - Song Ouyang
- Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 830000, P.R. China
| | - Jun Qian
- Institute of Urology, Hexi University, Zhangye, Gansu 734000, P.R. China
| | - Song Tu
- Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China
| | - Jiaxi Yao
- Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China
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11
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Guo J, Qiu F, Zhao J, Lu Q, Fu W, Xu Q, Huang D. Case Report: Retroperitoneal Sarcoma in Six Operations: Our Experience in Operative Management of Blood Vessels. Front Oncol 2022; 12:885033. [PMID: 35574413 PMCID: PMC9097944 DOI: 10.3389/fonc.2022.885033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Here we introduce a case of retroperitoneal liposarcoma, which is characterized by repeated recurrences after surgery, and has undergone a total of 6 operations. The diameter of the tumor was about 26 cm at the time of the patient's diagnosis. The imaging examination revealed that the surrounding organs and blood vessels were invaded, which brought great challenges to radical resection. The postoperative pathology of the patient’s first operation was dedifferentiated liposarcoma, and some areas showed myxofibrosarcoma differentiation. With the recurrence of sarcoma, myxofibrosarcoma dedifferentiated into rhabdomyosarcoma, and malignant fibrous histiocytoma appeared in some areas. How to treat this type of patient after recurrence? How to deal with blood vessels wrapped by sarcoma during surgery? The medical community has not yet reached the same conclusion. We describe the process of treating the patient and the experience of dealing with blood vessels during surgery.
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Affiliation(s)
- Jinhui Guo
- Qingdao Medical College, Qingdao University, Qingdao, China.,Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Fabo Qiu
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jie Zhao
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Qiliang Lu
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Wen Fu
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Qiuran Xu
- Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Dongsheng Huang
- Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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12
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Ye MS, Wu HK, Qin XZ, Luo F, Li Z. Hyper-accuracy three-dimensional reconstruction as a tool for better planning of retroperitoneal liposarcoma resection: A case report. World J Clin Cases 2022; 10:268-274. [PMID: 35071527 PMCID: PMC8727265 DOI: 10.12998/wjcc.v10.i1.268] [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: 03/09/2021] [Revised: 04/18/2021] [Accepted: 11/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Well-differentiated liposarcoma is the second most common pathologic type of retroperitoneal sarcoma. It is characterized by a huge mass, but multiple organ invasions are common. Surgery is the only treatment option for potential cure. Hyper-accuracy three-dimensional (3D) reconstruction is widely used in robotic partly nephrectomy owing to its ability to visualize overlapping anatomy.
CASE SUMMARY A 54-year-old man was admitted for progressive abdominal distension over the preceding 2 mo. Computed tomography revealed a 32 cm × 21 cm × 12 cm lipomatous mass. Hyper-accuracy 3D reconstruction was performed because of the complex relationship between the mass and nearby tissue. The patient underwent surgical resection, and the tumor did not recur for over 16 mo.
CONCLUSION Hyper-accuracy 3D reconstruction is useful for operative planning owing to its intuitiveness and precise determination of anatomical structures in both tumors and nearby tissues.
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Affiliation(s)
- Mu-Shi Ye
- Laboratory of Urology, The Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Guangzhou 524001, Guangdong Province, China
| | - Hao-Kai Wu
- Laboratory of Urology, The Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Guangzhou 524001, Guangdong Province, China
| | - Xing-Zhang Qin
- Laboratory of Urology, The Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Guangzhou 524001, Guangdong Province, China
| | - Fan Luo
- Laboratory of Urology, The Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Guangzhou 524001, Guangdong Province, China
| | - Zhuo Li
- Laboratory of Urology, The Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Guangzhou 524001, Guangdong Province, China
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13
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[Retroperitoneal soft tissue sarcoma: surgical management]. Chirurg 2021; 93:16-26. [PMID: 34596706 DOI: 10.1007/s00104-021-01506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Retroperitoneal soft tissue sarcomas are rare and heterogeneous tumors with high recurrence rates that require a multimodal treatment approach and a surgical resection strategy adapted to tumor localization and histological subtype. OBJECTIVE Based on current scientific data this article intends to provide an overview on subtype-specific features, prognostic factors and operative techniques in the surgical management of retroperitoneal soft tissue sarcomas. MATERIAL AND METHODS A review of the literature addressing surgical management of retroperitoneal soft tissue sarcomas was performed. Current evidence and recommendations were summarized. RESULTS AND CONCLUSION Macroscopically complete tumor resection represents the sole curative treatment option for both primary and recurrent retroperitoneal soft tissue sarcomas. To minimize the probability of tumor-infiltrated resection margins, compartmental resection has become a standard treatment for retroperitoneal soft tissue sarcomas. This approach includes resection of all organs and structures adjacent to the tumor. Multivisceral resection is often associated with this approach and it is acceptable in terms of morbidity and mortality if performed at a center with experience in retroperitoneal sarcoma surgery. Histologic subtype, tumor grading, and quality of initial surgical treatment are major prognostic factors for oncologic overall survival.
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Mulita F, Verras G, Liolis E, Tchabashvili L, Kehagias D, Kaplanis C, Perdikaris I, Kehagias I. Recurrent retroperitoneal liposarcoma: A case report and literature review. Clin Case Rep 2021; 9:e04717. [PMID: 34484756 PMCID: PMC8405415 DOI: 10.1002/ccr3.4717] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/10/2021] [Accepted: 07/30/2021] [Indexed: 02/05/2023] Open
Abstract
Retroperitoneal liposarcoma frequently recurs within 2 years of the initial surgical resection. For the early detection of recurrent retroperitoneal liposarcomas, a shorter follow-up interval with CT or MRI would be helpful.
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Affiliation(s)
- Francesk Mulita
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Elias Liolis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | - Levan Tchabashvili
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Dimitrios Kehagias
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Ioannis Perdikaris
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Ioannis Kehagias
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
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15
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Cao S, Li J, Yang K, Zhang J, Xu J, Feng C, Li H. Development and validation of a novel prognostic model for long-term overall survival in liposarcoma patients: a population-based study. J Int Med Res 2021; 48:300060520975882. [PMID: 33296604 PMCID: PMC7731721 DOI: 10.1177/0300060520975882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective To construct and validate a clinically accurate and histology-specific nomogram to predict overall survival (OS) among liposarcoma (LPS) patients. Methods We retrospectively screened eligible patients with LPS diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results database. We screened independent predictors for the nomogram using univariate and multivariate analyses. We then evaluated the prognostic accuracy of the nomogram by receiver operating characteristic (ROC) curve analysis and Harrell’s concordance index. The prognostic performances of the nomogram and the American Joint Committee on Cancer (AJCC) seventh edition staging system were compared using integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analyses (DCA). Results A novel nomogram was developed using independent prognostic variables, which exhibited excellent predictive performances for 3- and 5-year OS according to ROC curves. The C-index proved that the proposed nomogram had better prognostic accuracy for LPS than the traditional AJCC system, while the NRI, IDI, and DCA of the nomogram indicated better clinical net benefit. Conclusions The proposed nomogram can predict 3- and 5-year OS of LPS patients with reliable accuracy and may thus help clinicians to develop appropriate clinical therapies and counseling strategies to prolong the life expectancy of these patients.
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Affiliation(s)
- Shuai Cao
- Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jie Li
- Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Kai Yang
- Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jun Zhang
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Jiawei Xu
- Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Chaoshuai Feng
- Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Haopeng Li
- Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Haopeng Li, Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China.
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16
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Diagnosis and Prognosis of Retroperitoneal Liposarcoma: A Single Asian Center Cohort of 57 Cases. JOURNAL OF ONCOLOGY 2021; 2021:7594027. [PMID: 34035812 PMCID: PMC8116140 DOI: 10.1155/2021/7594027] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 12/17/2022]
Abstract
Background Liposarcoma is a soft tissue malignancy, commonly observed in the extremities. However, retroperitoneal liposarcoma is seldom reported and its diagnosis is frequently neglected. This study aims to present the clinical characteristics, diagnosis, and prognosis of five liposarcoma subtypes and report our experience of patient treatment. Methods We conducted a single-center noninterventional retrospective study of 57 retroperitoneal liposarcoma patients admitted to Peking Union Medical College Hospital (PUMCH, Beijing, China) between July 2011 and December 2019. We collected and analyzed their demographic, clinical, imaging, histological, therapeutic, and prognostic data over a mean 4.5-year follow-up period. Results Twenty-five (44%) patients were asymptomatic prior to diagnosis, with abdominal distension as the chief complaint in 18 (32%) patients and abdominal pain observed in 16 (28%) patients. Masses were evaluated by computed tomography (n = 48, 84%) or ultrasound (n = 25, 44%). Laparotomy (n = 52, 91%) was the dominant therapeutic modality rather than laparoscopy (n = 5, 9%). All patients were treated with R0 resection except two patients who underwent R2 resection. We conducted regular follow-ups every six months after surgery for a mean duration of 4.5 years. Recurrence was experienced by 14 (25%) patients and a further 9 (16%) died during follow-up. Conclusions Abdominal distension and pain are chief complaints with liposarcoma. As the extremities are the main liposarcomas locations, the diagnosis of retroperitoneal liposarcoma is usually neglected. Since half of the patients are asymptomatic, timely diagnosis and treatment are highly dependent on regular ultrasound and computed tomography imaging. R0 resection is the key to retroperitoneal liposarcoma treatment. In comparison, patients who underwent R2 resection, which is considered a palliative treatment, had bad prognoses. Large, symptomatic dedifferentiated, and pleomorphic liposarcomas are more likely to have poor prognoses, while the prognosis for well-differentiated or myxoid liposarcoma is relatively good.
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17
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Bachmann R, Eckert F, Gelfert D, Strohäker J, Beltzer C, Ladurner R. Perioperative strategy and outcome in giant retroperitoneal dedifferentiated liposarcoma-results of a retrospective cohort study. World J Surg Oncol 2020; 18:296. [PMID: 33183309 PMCID: PMC7664077 DOI: 10.1186/s12957-020-02069-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/27/2020] [Indexed: 12/25/2022] Open
Abstract
Background and objectives Retroperitoneal liposarcoma (RPLS) are common soft tissue sarcomas of adulthood. The aim of this study is to show resectability of even giant liposarcomas and to identify factors associated with recurrence and survival in primary retroperitoneal liposarcomas. Methods We retrospectively reviewed the records of patients with retroperitoneal liposarcoma. Seventy-seven patients met inclusion criteria. Out of these 10 patients with primary giant, dedifferentiated retroperitoneal liposarcomas were operated with en bloc compartment resection with intention of radical resection. Treatment consisted of neoadjuvant radiochemotherapy and surgical resection or surgical resection. Results In 6 patients, neoadjuvant radiochemotherapy was performed; 3 patients were treated with surgical resection alone and 1 patient received adjuvant chemotherapy. The median diameter of tumor size was 360 mm (300 to 440 mm). Operative outcome showed complete resection in all 10 patients. Local tumor free survival was in median 19 month. Tumor recurrence was seen in 3 of 4 patients (75%) without neoadjuvant radiochemotherapy, and in 2 of 6 patients (33%) after neoadjuvant radiochemotherapy in 2 years follow-up. Conclusion Even in case of giant retroperitoneal liposarcoma, complete resection is possible and remains the principal treatment. The rate of recurrence was improved in patients with neoadjuvant radiochemotherapy.
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Affiliation(s)
- Robert Bachmann
- Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
| | - Franziska Eckert
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
| | - Daniel Gelfert
- Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
| | - Jens Strohäker
- Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
| | - Christian Beltzer
- Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
| | - Ruth Ladurner
- Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
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18
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Xu C, Ma Z, Zhang H, Yu J, Chen S. Giant retroperitoneal liposarcoma with a maximum diameter of 37 cm: a case report and review of literature. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1248. [PMID: 33178780 PMCID: PMC7607090 DOI: 10.21037/atm-20-1714] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Retroperitoneal liposarcoma is a rare malignancy derived from adipocytes. They can grow to large sizes before inducing clinical symptoms. Giant retroperitoneal liposarcoma with a diameter over 30 centimeters is extremely rare. So far, only 13 cases of giant retroperitoneal liposarcoma with a diameter greater than 30 cm have been reported. There is very little experience in the treatment of these bulky tumors. Herein, we report a 65-year-old male patient diagnosed with giant retroperitoneal liposarcoma. The patient underwent successful complete surgical resection. The tumor was found to occupy almost the entire abdominal cavity, measuring 37.0 cm × 32.0 cm × 26.5 cm in size and 21.0 kg in weight. Histopathological analysis indicated a grade I, well-differentiated liposarcoma. The patient was discharged uneventfully, and no sign of recurrence was observed at 12-month follow-up. Moreover, we reviewed 13 literatures in English published on PubMed database regarding retroperitoneal liposarcoma greater than 30 cm in diameter. The analysis suggests that size alone should not be considered as a contraindication to surgical resection. Combined resection of adjacent organs is necessary if local invasion is confirmed. The role of adjuvant radio or chemotherapy remains controversial. Thorough evaluation on the extent of resection should be made to minimize post-surgery decline in quality of life.
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Affiliation(s)
- Chi Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhiqiang Ma
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Zhang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shuguang Chen
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Zhang S, Yan L, Cui C, Wang Z, Wu J, Zhao M, Dong B, Guan X, Tian X, Hao C. Identification of TYMS as a promoting factor of retroperitoneal liposarcoma progression: Bioinformatics analysis and biological evidence. Oncol Rep 2020; 44:565-576. [PMID: 32627015 PMCID: PMC7336505 DOI: 10.3892/or.2020.7635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 05/14/2020] [Indexed: 12/24/2022] Open
Abstract
Retroperitoneal liposarcoma (RLPS) is one of the most common types of retroperitoneal sarcomas, and has a high recurrence rate. There is an urgent need to further explore its pathogenesis and develop more effective treatment strategies. The aim of the present study was to identify potential driver genes of RLPS through bioinformatics analysis and molecular biology to elucidate potential targets that are suitable for further analysis for the treatment of RLPS. Differentially expressed genes (DEGs) between liposarcoma and normal fatty (NF) tissues were identified based on microarray data through bioinformatics analysis, and thymidylate synthase (TYMS) was selected from the DEGs, based on high content screening (HCS). TYMS expression was evaluated in RLPS tumor tissues and cell lines. A total of 21 RLPS tissues and 10 NF frozen tissues were used for reverse transcription-quantitative PCR, and 47 RLPS formalin-fixed specimens were used for immunohistochemical analysis. The effect of TYMS downregulation on cell proliferation, apoptosis, cell cycle progression, and cell migration and invasion were evaluated using lentivirus-mediated short hairpin RNA. The underlying mechanisms of TYMS in RLPS were examined by protein microarray and verified by western blotting. A total of 855 DEGs were identified. TYMS knockdown had the most notable effect on the proliferative capacity of RLPS cells according to the HCS results. TYMS mRNA expression levels were higher in RLPS tissues compared with NF tissues (P<0.001). TYMS expression was higher in high-grade RLPS tissues compared with low-grade RLPS tissues (P=0.003). The patients with positive TYMS expression had a worse overall survival (OS) and disease-free survival (DFS) compared with the patients with negative TYMS expression (OS, P=0.024; DFS, P=0.030). The knockdown of TYMS reduced proliferation, promoted apoptosis, facilitated cell cycle progression from G1 to S phase, and reduced cell migration and invasion of RLPS cells. Protein microarray analysis and western blotting showed that the Janus Kinase/Signal transducers and activators of transcription pathway was downregulated following TYMS knockdown. In conclusion, TYMS expression is upregulated in RLPS tissues, and downregulation of TYMS reduces RLPS progression.
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Affiliation(s)
- Sha Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Liang Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Can Cui
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Zhen Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Jianhui Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Min Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Bin Dong
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Central Laboratory, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Xiaoya Guan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Xiuyun Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
| | - Chunyi Hao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato‑Pancreato‑Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
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20
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Sbrana A, Paolieri F, Bloise F, Manacorda S, Nuzzo A, Sammarco E, Galli L, Falcone A. Dedifferentiated liposarcoma: when eribulin can make the difference. Future Oncol 2019; 16:21-24. [PMID: 31872768 DOI: 10.2217/fon-2019-0598] [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] [Indexed: 01/02/2023] Open
Abstract
We describe the case of a male subject affected by retroperitoneal advanced, anthracycline-pretreated liposarcoma, who experienced a long, beneficial clinical effect from eribulin treatment. In March 2013, a left, paraortic, retroperitoneal mass was surgically removed and diagnosed as Mdm2-positive dedifferentiated liposarcoma. In June 2015, a CT scan revealed disease progression and first-line epirubicin/ifosfamide treatment was started, followed by epirubicin in monotherapy. In January 2017, following a new disease progression, the patient started a second-line eribulin treatment that went on for about 1 year with no major adverse events. The CT scans performed every 3-4 months showed stable disease. After 13 months of treatment, a CT scan revealed disease progression and 10 days later, the patient died of bowel perforation and peritonitis.
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Affiliation(s)
- Andrea Sbrana
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Federico Paolieri
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Francesco Bloise
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Simona Manacorda
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Amedeo Nuzzo
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Enrico Sammarco
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Luca Galli
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Alfredo Falcone
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
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21
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Yoshida K, Yoshida M, Haisa M, Yukawa T, Monobe Y, Naomoto Y, Fukazawa T, Yamatsuji T. A case report of left lower lobe segmentectomy for pulmonary metastasis from retroperitoneal liposarcoma. Int J Surg Case Rep 2019; 61:169-173. [PMID: 31376737 PMCID: PMC6677788 DOI: 10.1016/j.ijscr.2019.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/14/2019] [Accepted: 07/18/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The principle treatment for retroperitoneal liposarcoma is surgical resection, however there are many cases of recurrence. In addition to local recurrence, retroperitoneal liposarcoma, particularly dedifferentiated liposarcoma is known to occasionally cause lung metastases. CASE REPORT A 72-year-old woman with a diagnosis of retroperitoneal liposarcoma and probable right upper lobe early pulmonary adenocarcinoma underwent sequential local tumor resection and right upper lobectomy. Twenty months after liposarcoma resection, a computed tomography (CT) scan of the chest revealed a nodule located in the left lower lobe. A CT-guided biopsy was performed and she was subsequently diagnosed with pulmonary metastasis from retroperitoneal liposarcoma. The nodule enlarged chronologically, however a left lower lobectomy could not be performed because respiratory function after the right upper lobectomy was not sufficient. Therefore, in order to preserve the left superior segment (S6), the basal segments (S8+S9+S10) were resected. Seven months after the surgery, she is living a self-reliant life without recurrence of liposarcoma. CONCLUSION Here we have reported a case of pulmonary metastasis from retroperitoneal liposarcoma following limited surgery. In cases where respiratory function is limited, lower lobe segmentectomy can be an effective treatment. For the treatment of a single pulmonary metastasis from retroperitoneal liposarcoma, metastasectomy was considered to be effective as long as no local recurrence was seen after initial primary tumor resection.
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Affiliation(s)
- Kazuhiro Yoshida
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan
| | - Masakazu Yoshida
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan
| | - Minoru Haisa
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan
| | - Takuro Yukawa
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan
| | - Yasumasa Monobe
- Department of Pathology 1, Kawasaki Medical School, Okayama, 700-8505, Japan
| | - Yoshio Naomoto
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan
| | - Takuya Fukazawa
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan.
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School, Okayama, 700-8505, Japan
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FU J, SONG F, CHENG A. [PET/CT imaging manifestations of different pathological subtypes of liposarcoma]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2019; 48:193-199. [PMID: 31309758 PMCID: PMC8800708 DOI: 10.3785/j.issn.1008-9292.2019.04.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/28/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To analyze PET/CT imaging manifestations of different pathological subtypes of liposarcoma. METHODS The 18F-fluorodeoxyglucose(FDG) PET/CT features of 13 patients pathologically confirmed as liposarcoma were retrospectively reviewed. The metabolism degree and distribution of different subtypes of liposarcoma were compared. RESULTS The well-differentiated liposarcoma showed fat density mass with septa and irregular strip with mild FDG uptake. The myxoid liposarcoma showed cystic or cystic solid mass, single or multiple with mild-moderate FDG uptake heterogeneously or homogeneously. The dedifferentiated liposarcoma showed mixed soft tissue mass with high FDG uptake heterogeneously, larger lesion with necrosis centrally. The mixed type contained well differentiated type and dedifferentiated type, and showed multiple lesion with combined imaging manifestations. There were local invasions in 12 cases, no lymph node matastasis, and the recurrence of dedifferentiated liposarcoma with lung metastasis in 1 case. The maximum standard values (SUVmax) of FNCCLE grade G1, G2 and G3 liposarcoma were 3.00, 5.67 and 10.33, respectively; there was significant difference between G1 and G3 groups, G2 and G3 groups (all P<0.05). CONCLUSIONS PET/CT manifestations of liposarcoma of various pathological subtypes are different. Preoperative PET/CT examination can clarify the pathological types, scope of tumor invasion and metastasis of liposarcoma, which provides more information for clinical decision-making and is helpful for the preparation of surgical plan.
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Affiliation(s)
| | | | - Aiping CHENG
- 程爱萍(1968-), 女, 博士, 主任医师, 主要从事肿瘤核医学研究, E-mail:
,
https://orcid.org/0000-0003-4642-4426
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23
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Mandato VD, Mastrofilippo V, De Marco L, Aguzzoli L. Laparoscopic approach to an incidentally found pelvic retroperitoneal liposarcoma: Case report and review. Medicine (Baltimore) 2019; 98:e15184. [PMID: 30985710 PMCID: PMC6485822 DOI: 10.1097/md.0000000000015184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
RATIONALE Well-differentiated liposarcomas (WDLPS) are rare retroperitoneal tumors that can reach significant size as they can grow without constrains before becoming symptomatic. Laparotomic open radical tumor resection represents the most common surgical approach. PATIENT CONCERNS A mass with "fat fluid level" was found in the right pelvis of an asymptomatic woman undergoing routine transvaginal ultrasound: the preoperative diagnosis was right mature ovarian teratoma. DIAGNOSIS Postoperative histopathology confirmed the diagnosis of WDLPS. INTERVENTIONS A radical laparoscopic excision of the retroperitoneal mass with bilateral salpingectomy was performed. OUTCOMES Patient is free of disease at 18 months after surgery. LESSON Despite computed tomography scan is the gold standard technique to identify WDLPS, such neoplasms can be misdiagnosed for mature ovarian teratomas. When a retroperitoneal mass is incidentally discovered during a surgery, an open core-needle biopsy is usually performed, and appropriate treatment planned only after complete staging and final pathology are available. Instead, when tumor margins are identified, resection of an incidentally diagnosed WDLPS would benefit from laparoscopic magnification that could improve distinguishing the disease from the surrounding tissues. Therefore, laparoscopy could represent a safe and effective technique to diagnose and treat retroperitoneal diseases.
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Affiliation(s)
| | | | - Loredana De Marco
- Unit of Pathology, Azienda USL-IRCCS of Reggio Emilia, Risorgimento, Italy
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24
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Moyon FX, Moyon MA, Tufiño JF, Yu A, Mafla OL, Molina GA. Massive retroperitoneal dedifferentiated liposarcoma in a young patient. J Surg Case Rep 2018; 2018:rjy272. [PMID: 30310651 PMCID: PMC6174626 DOI: 10.1093/jscr/rjy272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/12/2018] [Accepted: 09/24/2018] [Indexed: 12/22/2022] Open
Abstract
Liposarcomas are rare malignant tumors that mostly develop in the retroperitoneum. They have a broad behavioral spectrum, from small masses of tissue to highly aggressive tumors. The dedifferentiation process occurs in up to 10% and it's most likely to occur in the retroperitoneum, a process that not only changes its components but also its prognosis. These tumors can grow to a massive size since most of them do not give any symptoms until they invade the adjacent structures. Timely detection and surgery could avoid all these potentially lethal scenarios. We present a case of a 34-year-old patient, who reported a growing mass in her abdomen that reached massive proportions but remained untreated due to lack of sufficient access to healthcare facilities in her geographic location. After complete removal of the mass the patient underwent complete recovery, dedifferentiated liposarcoma was the final diagnosis.
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Affiliation(s)
- Fernando X Moyon
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Miguel A Moyon
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Jorge F Tufiño
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Alberto Yu
- PGY4 Resident General Surgery, P.U.C.E., Quito, Ecuador
| | - Oscar L Mafla
- PGY4 Resident General Surgery, P.U.C.E., Quito, Ecuador
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Abstract
RATIONALE Liposarcoma is a cancerous mesenchymal tumor and the most common soft-tissue sarcoma that starts in the adipose tissue. Liposarcoma is commonly found in lower extremities and retroperitoneum, but rarely occurs in the mediastinum. PATIENT CONCERNS A 63-year-old male was referred to our clinic with a 6-month history of chronic cough and dyspnea. DIAGNOSE Chest x-rays demonstrated a large mass occupying the left hemithorax. Contrast-enhanced computed tomography (CT) revealed a large mass in the anterior mediastinum, which caused the extrinsic compression of the main and left pulmonary artery and the right shift of mediastinum. Diagnosis of liposarcoma was confirmed by microscopic examination and immunohistochemistry analysis. INTERVENTIONS The patient underwent a thoracotomy for resection of the mediastinal lesion via left thoracic approach. OUTCOMES The patient discharged without any complications and has been continuing to follow up in clinic without any complaints. LESSONS The primary mediastinal liposarcoma is rare, and we recommend that the liposarcoma should be considered in the differential diagnosis of a patient presenting with a mediastinal mass.
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Affiliation(s)
- Yu-Shang Yang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan
- Department of Thoracic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Cheng-Yun Bai
- Department of Thoracic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Zhong-Cheng Li
- Department of Thoracic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Wen-Jun Li
- Department of Thoracic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Yong Li
- Department of Thoracic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
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Hashimoto K, Nishimura S, Akagi M. A Case of Atypical Lipomatous Tumor that Dedifferentiated with Second Recurrence after Additional Resection. Cureus 2018; 10:e2954. [PMID: 30214842 PMCID: PMC6132678 DOI: 10.7759/cureus.2954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Dedifferentiated liposarcoma is recognized as a type of liposarcoma that usually occurs concomitantly with the well-differentiated type. In this report, we discuss the case of a 65-year-old man who developed a dedifferentiated liposarcoma with second recurrence of an atypical lipomatous tumor. The patient first presented to us with an atypical lipomatous tumor of the right elbow for which he underwent a marginal resection. After five months, the patient experienced tumor recurrence for which he underwent another extended resection. Approximately 10 months following this surgery, the tumor recurred a second time for which he underwent another extended resection. Histopathological analysis of the second recurring tumor revealed a dedifferentiated liposarcoma. So far, two years following this resection, recurrence has not been observed. This is the first case of an atypical lipomatous tumor that dedifferentiated after the additional extended resection.
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Affiliation(s)
| | - Shunji Nishimura
- Orthopedic Surgery, Kindai University Hospital, Osakasayama, JPN
| | - Masao Akagi
- Orhtopedic Surgery, Kindai University Hospital, Osakasayama, JPN
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