title: Primary intra-osseous liposarcoma of the femur: a case report.
abstract: We report a rare case of an intra-osseous liposarcoma of the proximal femur. A 26-year-old man presented with a 6-month history of left groin pain radiating to the knee and an antalgic gait. Radiology showed a predominantly fatty lesion in the medial aspect of the femoral neck extending toward the lesser trochanter; most of the marrow in the femoral neck had been replaced without evidence of an extra-osseous mass; and the posterior cortex had been destroyed. Histological and immunohistochemical analyses of the tumour after open biopsy were indicative of high-grade liposarcomatous malignancy. After exclusion of any other primary tumour foci or metastases on regional and whole-body magnetic resonance images, the diagnosis of a high-grade intra-osseous primary liposarcoma of the proximal femur was made. The patient received 2 preoperative courses of neoadjuvant doxorubicin, cisplatin and methotrexate. After proximal femoral replacement following en bloc excision of the proximal femur, 4 more cycles of adjuvant ifosfamide and etoposide were given. At the 16-month follow-up, he remained independently ambulatory, with no local or distant recurrence. Tissue diagnosis and multimodal imaging, rather than any single radiological investigation, are important in making the diagnosis.
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, United Kingdom. simonmacmull@hotmail.com
authors.forename: Simon
authors.initials: S
authors.lastname: Macmull
authors.forename: Henry Dushan Edward
authors.initials: HD
authors.lastname: Atkinson
authors.forename: Srdjan
authors.initials: S
authors.lastname: Saso
authors.forename: Roberto
authors.initials: R
authors.lastname: Tirabosco
authors.forename: Paul
authors.initials: P
authors.lastname: O'Donnell
authors.forename: John Andrew
authors.initials: JA
authors.lastname: Skinner
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008080:Liposarcoma / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D020360:Neoadjuvant Therapy; D011859:Radiography; D051598:Whole Body Imaging
chemical_list: D005047:Etoposide; D004317:Doxorubicin; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate