Retroperitoneal dedifferentiated liposarcoma with huge cystic degeneration: A case report

Pathol Int. 2017 May;67(5):264-268. doi: 10.1111/pin.12525. Epub 2017 Mar 23.

Abstract

Prominent cyst formation is an unusual feature of liposarcoma. We report here a case of dedifferentiated liposarcoma with huge cystic change without preoperative chemo- or radiation therapy. The lesion arose in the retroperitoneum juxtaposed to the right kidney of a 67-year-old woman. She underwent a surgical removal of the retroperitoneal cyst. The cystic tumor contained 1600 mL of old bloody fluid, and its wall was composed of edematous, inflamed or sclerosing fibrous tissue with fatty tissue containing abundant atypical stromal cells, which were immunohistochemically positive for MDM2 and CDK4, and demonstrated MDM2 gene amplification by fluorescence in situ hybridization. The wall was contiguous to an atypical lipomatous nodule located in the mesentery. The following surgical specimens of the right hemicolectomy and right nephrectomy revealed atypical cells infiltrating into the subserosa of the colon and the perirenal fat tissue or that in the renal sinus. This case indicates that well differentiated or dedifferentiated liposarcoma should be also considered as a differential diagnosis of perirenal cystic mass.

Keywords: dedifferentiated liposarcoma; histopathology; perirenal cyst; retroperitoneal tumor.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cyclin-Dependent Kinase 4 / metabolism*
  • Cysts / diagnostic imaging
  • Cysts / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Lipoma / diagnostic imaging*
  • Lipoma / pathology
  • Liposarcoma / diagnostic imaging*
  • Liposarcoma / pathology
  • Magnetic Resonance Imaging
  • Proto-Oncogene Proteins c-mdm2 / metabolism*
  • Retroperitoneal Neoplasms / diagnostic imaging*
  • Retroperitoneal Neoplasms / pathology

Substances

  • MDM2 protein, human
  • Proto-Oncogene Proteins c-mdm2
  • CDK4 protein, human
  • Cyclin-Dependent Kinase 4

Supplementary concepts

  • Retroperitoneal liposarcoma