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Front Oncol. 2016 Jun 10;6:134. doi: 10.3389/fonc.2016.00134. eCollection 2016.

Hypothesis: The Intratumoral Immune Response against a Cancer Progenitor Cell Impacts the Development of Well-Differentiated versus Dedifferentiated Disease in Liposarcoma.

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Section of Surgical Oncology, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Sarcoma Program, Hoag Family Cancer Institute, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA.
Department of Pathology, Keck School of Medicine, University of Southern California , Los Angeles, CA , USA.
Department of Pathology, Stanford University School of Medicine , Palo Alto, CA , USA.
Division of Surgical Oncology, Department of Surgery, The James Comprehensive Cancer Center, Ohio State University , Columbus, OH , USA.


Well-differentiated/dedifferentiated (WD/DD) liposarcoma is a rare malignancy of adipocyte origin ("fat cancer"). Tumors may be entirely WD, WD with a DD component, or rarely DD without a clear WD component. WD tumors are low grade and generally indolent, while tumors with a DD component are high grade and behave much more aggressively, with a modest potential for distant metastasis. The presence of cancer progenitor cells in WD/DD liposarcoma is suggested by clinical evidence and reported research findings. In addition, there are emerging data to support the existence of a naturally occurring, antigen-driven, and adaptive immune response within the tumor microenvironment. We hypothesize that the intratumoral immune response is directed against a cancer progenitor cell and that the outcome of this response impacts the development of WD versus DD disease. Further study will likely provide interesting insights into the disease biology of WD/DD liposarcoma that may be readily translated to other more common cancers.


cancer stem cells; dedifferentiation; ectopic lymph node; liposarcoma; tertiary lymphoid structures; tumor-initiating cells

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