title: Surgery for dedifferentiated liposarcoma, presenting two radiologically and pathologically distinctive patterns.
abstract: In this paper, we report three cases with dedifferentiated liposarcoma in the lower extremities, presenting two patterns that are distinctively different radiologically and pathologically. The first case was a 67-year-old male who had discovered a mass in his left thigh, which was shown as a low and iso density mass between the muscles on computed tomography (CT). The second case was a 61-year-old male who had suffered from an intramuscular tumor with a non-fatty sarcomatous area within the fatty components as shown on magenetic resonance imaging (MRI). The third case was a 52-year-old female who had presented with an intramuscular tumor of the left thigh, consisting of a mass with fat and another soft tissue tumor adjacent to the lipomatous component as detected with CT and MRI. The final pathological diagnoses of the resected specimens in all three cases were concluded to be dedifferentiated liposarcoma, composed of well-differentiated liposarcomas and spindle and/or pleomorphic sarcomas, compatible with malignant fibrous histiocytoma. In all three cases, wide resection of the tumor was successfully carried out, and all patients have been continuously disease-free up to the most recent follow-up. Evaluation of the surgical margins for the resected specimens indicated that the safety margin for a dedifferentiated lesion should be accomplished as an adequate margin or more, and a marginal margin or more could be considered as safe only for the confined part of a well-differentiated liposarcoma.
authors.affiliation: Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hoshi
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Jun
authors.initials: J
authors.lastname: Manabe
authors.forename: Taisuke
authors.initials: T
authors.lastname: Tanizawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Shigemitsu
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Koyanagi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ae
authors.forename: Kengo
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kawaguchi
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007866:Leg; D008080:Liposarcoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed