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Teixeira FR, Arakaki MS, Lima HVG, Ferreira FDO, Menegozzo CAM, Silva ER, Montero EFDS, Oya T, Lima LC, Akaishi EH, Utiyama EM. Multivisceral resection for retroperitoneal liposarcoma-is it worth it? A 20-year single-center experience. Surg Today 2023; 53:1181-1187. [PMID: 37606758 DOI: 10.1007/s00595-023-02731-8] [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: 11/07/2022] [Accepted: 02/23/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Soft tissue sarcomas are rare malignant tumors. Liposarcoma constitutes the most frequent histological subtype of retroperitoneal sarcoma. The prognosis of soft tissue sarcomas depends on clinical and histologic characteristics. OBJECTIVE Evaluate variables that may be related to the overall and local recurrence-free survival in patients with retroperitoneal liposarcoma and discuss the need for visceral resection en-bloc for tumors. METHODS A retrospective analysis was conducted of the medical records of 60 patients seen between 1997 and 2017 who underwent surgical resection of retroperitoneal liposarcoma. RESULTS The overall survival rate at 5 years of follow-up was 75.22% (95% confidence interval [CI] 0.58-0.86). The probability of a local recurrence-free survival at 5 years of follow-up was 26.04% (95% CI 0.11-0.44). The multivariate analysis showed that dedifferentiated or pleomorphic tumors and R2/fragmented resection were associated with a shorter time to recurrence. No other characteristics markedly influenced the overall survival (P > 0.05). CONCLUSION Patients with dedifferentiated or pleomorphic tumors and incomplete resection were associated with higher local recurrence rates than others. This study reinforces the need for complete and en-bloc resection with organs when there is clear involvement or technical surgical difficulty to maintain the tumor integrity.
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Affiliation(s)
- Frederico Ribeiro Teixeira
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
| | - Mariana Sousa Arakaki
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
| | - Helber Vidal Gadelha Lima
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil.
| | - Fabio de Oliveira Ferreira
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
| | - Carlos Augusto Metidieri Menegozzo
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
| | - Eduardo Rissi Silva
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
| | - Edna Frasson de Souza Montero
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
- Laboratory of Surgical Physiopathology (LIM-62), Hospital das Clínicas (HCFMUSP), São Paulo, Brazil
| | - Toshiko Oya
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
- Nurse of Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), São Paulo, Brazil
| | - Luiz Calima Lima
- Soft Tissue Sarcoma Pathologist-Cancer Institute of the State of São Paulo (ICESP), São Paulo, Brazil
| | - Eduardo Hiroshi Akaishi
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
| | - Edivaldo Massazo Utiyama
- Divisão de Clínica Cirúrgica III - Hospital das Clínicas (HCFMUSP), Instituto Central do Hospital das Clínicas da Universidade de São Paulo, 8º andar, sala 8131, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, SP, 05402-000, Brazil
- Laboratory of Surgical Physiopathology (LIM-62), Hospital das Clínicas (HCFMUSP), São Paulo, Brazil
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Eisenhardt AE, Schmid A, Esser J, Brugger Z, Lausch U, Kiefer J, Braig M, Runkel A, Wehrle J, Claus R, Bronsert P, Leithner A, Liegl-Atzwanger B, Zeller J, Papini R, von Laffert M, Pfitzner BM, Koulaxouzidis G, Giunta RE, Eisenhardt SU, Braig D. Targeted next-generation sequencing of circulating free DNA enables non-invasive tumor detection in myxoid liposarcomas. Mol Cancer 2022; 21:50. [PMID: 35164780 PMCID: PMC8842903 DOI: 10.1186/s12943-022-01523-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/26/2022] [Indexed: 12/17/2022] Open
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Ushida Y, Ito H, Inoue Y, Sato T, Ono Y, Oba A, Takahashi Y. Liposarcoma of gallbladder: a case report and literature review. J Surg Case Rep 2021; 2021:rjab273. [PMID: 34168860 PMCID: PMC8219400 DOI: 10.1093/jscr/rjab273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
A 53-year-old man with prior history of resection of liposarcoma in his leg presented with gallbladder mass. Computed tomography showed 4-cm tumor at gallbladder fundus with weak enhancement with IV contrast. Differential diagnoses included hemangioma and liposarcoma, and laparoscopic cholecystectomy was recommended. In the operating room, the tumor appeared without serosal and liver invasions and uncomplicated laparoscopic cholecystectomy was completed. Histopathological examination revealed the tumor as myxoid liposarcoma with round cells. Adjuvant chemotherapy was not given, and he was placed on imaging surveillance. At 16 months after the operation, he developed recurrence of liposarcoma in the left popliteal fossa.
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Affiliation(s)
- Yuta Ushida
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Hiromichi Ito
- Correspondence address. Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. Tel: +81-3-3520-6111; Fax: +81-3-3570-0343; E-mail:
| | - Yosuke Inoue
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Takafumi Sato
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Yoshihiro Ono
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Atsushi Oba
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Yu Takahashi
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
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Abstract
Localization of metastases into the parotid gland is a very uncommon event. Usually they arise from primary tumors located in the head and neck, mainly melanoma or epidermoid carcinoma of the skin, while other histotypes, from others anatomical districts, hardly have a metastatic spread to the parotid. Myxoid liposarcoma (MLS) is a rare malignant tumor of the soft tissue that mainly occurs in the extremities, representing the second most common subtype of liposarcoma. Although it is typical for liposarcomas to metastasize to the lungs, it is known that MLS can spread also to extra pulmonary sites. The authors report a case of myxoid liposarcoma of the left thigh in a 64-year-old man, with an unusual metastatic double presentation to the contralateral forearm first and to the parotid gland then. MLS with metastatic disease to the parotid gland is an extremely rare event with very few cases reported in the English literature.
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Alawad I, Al-Haj A, Ghazal A, Ibrahim A, Masri R. A Neglected Case of Multifocal Liposarcoma Presented in Five Different Sites in a Syrian Woman: A case report. Int J Surg Case Rep 2019; 65:262-266. [PMID: 31743843 PMCID: PMC6864296 DOI: 10.1016/j.ijscr.2019.10.077] [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: 07/31/2019] [Revised: 10/27/2019] [Accepted: 10/29/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Multifocal soft tissue sarcoma is a rare clinical entity occurring in 1 % of patients with extremity soft tissue sarcoma and in 4.5 % of patients with liposarcoma. Multifocal disease may arise either synchronously or metachronously and has been associated with poor prognosis. CASE PRESENTATION Herein, we report a rare case of a Syrian woman patient with six different foci of liposarcoma in five sites at the time of diagnosis. DISCUSSION Liposarcomas are currently classified into four different subtypes based on histologic or genetic analysis according to the World Health Organization (WHO), including cell-differentiated, dedifferentiated, myxoid, and pleomorphic. In the present work, we report a neglected patient with a multicentric round cell liposarcoma in five different sites. CONCLUSION Medicine cannot provide much care for these advanced cases of multicentric liposarcoma so far. Therefore, more research should be conducted to improve the ability to manage these entities and to identify potential novel therapies.
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Affiliation(s)
- Ieman Alawad
- Aleppo University Hospital for Obstetrics and Gynecology, University of Aleppo, Aleppo, Syria.
| | - Ahmad Al-Haj
- Department of Surgery, University of Aleppo, Aleppo, Syria.
| | - Ahmad Ghazal
- Department of Surgery, University of Aleppo, Aleppo, Syria.
| | - Amna Ibrahim
- Department of Internal Medicine, University of Aleppo, Aleppo, Syria.
| | - Ruqaya Masri
- Department of Surgery, University of Aleppo, Aleppo, Syria.
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Dürr HR, Rauh J, Baur-Melnyk A, Knösel T, Lindner L, Roeder F, Jansson V, Klein A. Myxoid liposarcoma: local relapse and metastatic pattern in 43 patients. BMC Cancer 2018; 18:304. [PMID: 29558901 PMCID: PMC5859402 DOI: 10.1186/s12885-018-4226-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 03/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Liposarcomas are the second most common type of soft tissue sarcomas, 30-50% of these are of myxoid subtype. The aim of this retrospective study was to analyze the local control rate, the metastatic pattern and survival of patients in a consecutive single-institution series. METHODS From 1983 to 2015, 43 patients with myxoid liposarcoma of the extremities and trunk wall underwent resections. The margin was defined as R0 (wide) or R1 (marginal). Patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival was calculated. RESULTS The mean age was 48.6 years. The lower extremity was involved in 40 cases, the mean tumour size was 12 cm. In 31 cases a wide and in 12 cases a marginal resection was performed. Grading was G1 in 14, G2 in 25 and G3 in 4 cases. Nine patient died in follow-up, 4 of them with metastatic disease, all nonpulmonary. 5-year local recurrence (LR) free survival was 82%. 4 (9.3%) patients developed LR (all R1). Overall survival (OS) was 81% after 5 and 72% after 10 years. In multivariate analysis age and Grading proved to be significant on OS. According to univariate analysis, only age over 48 years and distant metastasis had a significant impact on overall survival. CONCLUSIONS Patients with myxoid liposarcomas have a good prognosis. Myxoid liposarcoma has a distinct pattern of nonpulmonary metastatic disease. Therefore, patients with high-risk extremity myxoid liposarcoma should undergo imaging studies of the chest, abdomen, spine and pelvis as part of their staging and follow-up examinations preferably with whole body MRI, or CT scans and MRI of the spine and pelvic region for detection of suspected metastatic disease.
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Affiliation(s)
- Hans Roland Dürr
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Jessica Rauh
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Andrea Baur-Melnyk
- Institute of Radiology, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Thomas Knösel
- Institute of Institute of Pathology, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Lars Lindner
- Department of Medicine III, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Falk Roeder
- Department of Radiation Oncology, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,CCU Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Volkmar Jansson
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Alexander Klein
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Grosshadern, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
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Establishment and characterization of a new human myxoid liposarcoma cell line (DL-221) with the FUS-DDIT3 translocation. J Transl Med 2016; 96:885-94. [PMID: 27270875 PMCID: PMC4965313 DOI: 10.1038/labinvest.2016.64] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/18/2016] [Indexed: 12/19/2022] Open
Abstract
Myxoid liposarcoma has the pathognomonic fusion oncogene FUS-DDIT3 encoding a chimeric transcription factor. Metastatic risk is higher with an increased round cell component and has been linked to aberrations involving the IGFR/PI3K/AKT pathway. These molecular insights have yet to translate to targeted therapies, and the lack of experimental models is a major hindrance. We describe the initial in-depth characterization of a new cell line (DL-221) and establishment of a mouse xenograft model. The cell line DL-221 was derived from a metastatic pleural lesion showing myxoid and round cell histology. This newly established cell line was characterized for phenotypic properties and molecular cytogenetic profile, using PCR, COBRA-FISH, and western blot. Next-generation whole-exome sequencing was performed to further characterize the cell line and the parent tumor. NOD-SCID-IL2R gamma knockout mice were xenograft hosts. DL-221 cells grew an adhering monolayer and COBRA-FISH showed an aneuploid karyotype with t(12;16)(q13;p11) and several other rearrangements; RT-PCR demonstrated a FUS-DDIT3 fusion transcript type 1. Both the cell line and the original tumor harbored a TP53 compound heterozygous mutation in exon 4 and 7, and were wild-type for PIK3CA. Moreover, among the 1254 variants called by whole-exome sequencing, there was 77% concordance between the cell line and parent tumor. The recently described hotspot mutation in the TERT promoter region in myxoid liposarcomas was also found at C228T in DL-221. Xenografts suitable for additional preclinical studies were successfully established in mice after subcutaneous injection. The established DL-221 cell line is the only published available myxoid liposarcoma cell line that underwent spontaneous immortalization, without requiring SV40 transformation. The cell line and its xenograft model are unique and helpful tools to study the biology and novel potential-targeted treatment approaches for myxoid liposarcoma.
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Nowrasteh G, Aziz T, Al Assas M, Al Nuaimi L, Marzouqi S, Quadri AAM, Alrawi S. Metachronous Bilateral Extremity Soft Tissue Sarcomas. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:12-7. [PMID: 26744032 PMCID: PMC4718140 DOI: 10.12659/ajcr.892402] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Soft tissue sarcomas (STS) account for approximately 1% of adult malignancies, with 50 to 60% occurring in the extremities. Liposarcoma is the most common type of STS and represent about 20% of total adult sarcomas. There are rare syndromes associated with increased risk of developing STS. Further, chemical compounds such as chlorinated phenols and a few chemotherapeutic drugs have been linked to STS, along with ionizing radiation. Nevertheless, the etiology is uncertain for most of these lesions. CASE REPORT This report details 2 cases of metachronous bilateral STS of the lower extremities. The first of these presented as a local recurrence of a previously resected right thigh liposarcoma and a new liposarcoma in the left thigh. As mentioned above, among the different subtypes of STS, liposarcoma has the highest tendency for multifocality. The second patient had multifocal metachronous leiomyosarcoma with lung metastases occurring simultaneously with the second presentation. Leiomyosarcoma is another subtype reported to present with multifocal disease. CONCLUSIONS Despite the rarity of bilateral lesions, their occurrence should not be overlooked in the initial diagnosis and follow-up of the initially detected tumor. Early detection can affect patient survival because their presence predicts unfavorable outcomes.
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Affiliation(s)
- Ghodratollah Nowrasteh
- Department of Surgery, Division of Surgical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Tanim Aziz
- Department of Surgery, Division of Surgical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Mohammed Al Assas
- Department of Surgery, Division of Surgical Oncology, Al Mafraq Hospital, Abu Dhabi, United Arab Emirates
| | - Lateefa Al Nuaimi
- Department of Surgery, Division of Surgical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Saeeda Marzouqi
- Department of Pathology, FMHS, UAE Unuversity, Al Ain, United Arab Emirates
| | - Asif A M Quadri
- Department of Pathology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Sadir Alrawi
- Department of Surgery, Division of Surgical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
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Olimpiadi Y, Song S, Hu JS, Matcuk GR, Chopra S, Eisenberg BL, Sener SF, Tseng WW. Contemporary Management of Retroperitoneal Soft Tissue Sarcomas. Curr Oncol Rep 2015; 17:39. [DOI: 10.1007/s11912-015-0462-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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10
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Brooks JSJ, Lee S. Contemporary diagnostics: sarcoma pathology update. J Surg Oncol 2015; 111:513-9. [PMID: 25689920 DOI: 10.1002/jso.23853] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/10/2014] [Indexed: 11/10/2022]
Abstract
Sarcoma diagnosis continues to evolve as new information is discovered. Certain tumors have been downgraded (dermal leiomyosarcoma) and an atypical category designed for others. Recently entities include myxoinflammatory fibroblastic sarcoma, myoepithelioma, and pseudomyogenic hemangioendothelioma. The terms malignant fibrous histiocytoma and hemangiopericytoma are outdated. New immunostains (STAT6, SOX10, ERG) add diagnostic specificity, and new risk assessment models are described for sarcomas where grading and staging has failed to provide adequate prognosis.
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Affiliation(s)
- John S J Brooks
- Perlman School of Medicine, University of Pennsylvania, Chair of Pathology, Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia, Pennsylvania; Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia, Pennsylvania
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Vargas Pierola HJ, Muñoz Muñoz E, Sánchez Martínez A, González Pont G, Veloso Veloso E. Liposarcoma multicéntrico sincrónico y metacrónico. Cir Esp 2014; 92:441-3. [DOI: 10.1016/j.ciresp.2012.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 04/30/2012] [Indexed: 11/25/2022]
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Salemis NS, Seretis C, Seretis F, Christofyllakis C, Karalis G. Metachronous multifocal myxoid liposarcoma involving the gastrointestinal tract. Management and literature review. J Nat Sci Biol Med 2014; 5:186-90. [PMID: 24678225 PMCID: PMC3961932 DOI: 10.4103/0976-9668.127325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Multifocal soft tissue sarcoma is a rare clinical entity occurring in 1% of patients with extremity soft tissue sarcoma and in 4.5% of patients with liposarcoma. Multifocal disease may arise either synchronously or metachronously and has been associated with poor prognosis. Herein, we have described a rare case of metachronous multifocal myxoid liposarcoma involving the gastrointestinal tract that developed 14 months after the resection of a myxoid buttock liposarcoma. Diagnostic evaluation and management of the patient are discussed along with a review of the relevant literature. We conclude that multifocal myxoid liposarcoma is a rare clinical entity that usually represents metastatic disease with poor prognosis. A thorough imaging and careful physical examination are essential in the preoperative evaluation and postoperative follow-up of patients with myxoid extremity liposarcomas, as these tumors are known to have a tendency to spread toward extrapulmonary sites, frequently without pulmonary metastases.
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Affiliation(s)
| | | | - Fotios Seretis
- Department of Surgery, Army General Hospital, Athens, Greece, Europe
| | | | - Georgios Karalis
- Department of Surgery, Army General Hospital, Athens, Greece, Europe
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Tseng WW, Somaiah N, Lazar AJ, Lev DC, Pollock RE. Novel systemic therapies in advanced liposarcoma: a review of recent clinical trial results. Cancers (Basel) 2013; 5:529-49. [PMID: 24216990 PMCID: PMC3730323 DOI: 10.3390/cancers5020529] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 04/16/2013] [Accepted: 05/02/2013] [Indexed: 12/23/2022] Open
Abstract
Liposarcoma is one of the most common adult soft tissue sarcomas an consists of three histologic subtypes (well and dedifferentiated, myxoid/round cell, and pleomorphic). Surgery is the mainstay of treatment for localized disease; however for unresectable or metastatic disease, effective treatment options are currently limited. In the past decade, a better understanding of the distinct genetic and molecular aberrations for each of the three histologic subtypes has led to the development of several novel systemic therapies. Data from phase I and early phase II clinical trials have been reported. Despite challenges with conducting clinical trials in liposarcoma, preliminary results for several of these novel, biology-driven therapies are encouraging.
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Affiliation(s)
- William W. Tseng
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Neeta Somaiah
- Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Alexander J. Lazar
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Dina C. Lev
- Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Raphael E. Pollock
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
- Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-713-792-6928; Fax: +1-713-563-4637
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