title: Dedifferentiated liposarcoma with an inflammatory malignant fibrous histiocytoma-like component presenting a leukemoid reaction.
abstract: A rare case of dedifferentiated liposarcoma (well-differentiated liposarcoma with an inflammatory malignant fibrous histiocytoma (MFH)-like anaplastic component) occurring in a 69-year-old male is presented. The patient had noticed a dull pain in his left loin and thigh for about 1 month. Computed tomography examination revealed a low-density mass lesion, measuring about 6 cm in diameter, in the left iliopsoas muscle, and it was surgically removed. Grossly, the lesion was composed of an encapsulated, soft, whitish mass and an adjacent, well-demarcated, yellowish hard nodule, measuring about 2.5 cm in diameter. Microscopically, both lesions showed features of an inflammatory variant of MFH and a sclerosing type of well-differentiated liposarcoma, respectively. To our knowledge, only two cases of dedifferentiated liposarcoma combined with inflammatory MFH as a dedifferentiated component have been recorded in the literature. The salient feature of the present case is a systemic inflammatory reaction, as shown by prominent leukocytosis (up to 73,900/mm3) and the elevated serum value of C reactive protein (up to 26.0 mg/dL), which were transiently reduced after surgery. The inflammatory reaction was suggested to be induced by cytokines, such as granulocyte colony-stimulating factor and interleukin-6, which were probably produced by the tumor cells in the present case, because the elevated serum values of those cytokines were decreased after surgery.
authors.affiliation: Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hisaoka
authors.forename: S
authors.initials: S
authors.lastname: Tsuji
authors.forename: H
authors.initials: H
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Aoki
authors.forename: K
authors.initials: K
authors.lastname: Uriu
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D017809:Fatal Outcome; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D018219:Histiocytoma, Benign Fibrous / Q000737:chemistry / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D015850:Interleukin-6 / Q000097:blood; D007955:Leukemoid Reaction / Q000473:pathology*; D008080:Liposarcoma / Q000737:chemistry / Q000473:pathology*; D008297:Male; D019042:Muscle Neoplasms / Q000737:chemistry / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D015850:Interleukin-6; D016179:Granulocyte Colony-Stimulating Factor; D002097:C-Reactive Protein