title: Primary dermal pleomorphic liposarcoma: utility of adipophilin and MDM2/CDK4 immunostainings.
abstract: Liposarcoma, usually arises in deep soft tissues and pleomorphic liposarcoma (PL), is the rarest histopathologic variant. However, 15 cases of entirely dermal PL have been reported. We describe a case of a 79-year-old man who developed a rapidly growing nodule on his thorax. Excisional biopsy was performed and immunohistochemical studies were carried. The lesion was a well-circumscribed dermal nodule composed of multivacuolated pleomorphic lipoblasts and atypical mitotic figures. Neoplastic cells expressed CD10 and resulted negative S100 protein, Melan-A, MITF-1, AE1/AE3, CD4, CD68 (PGM1), retinoblastoma gene family protein, pericentrine and lysozyme. Adipophilin stain showed the lipid contents in the cytoplasm of the neoplastic cells. MDM2 and CDK4 resulted both negative. A diagnosis of primary dermal PL was made. This case shows the utility of adipophilin immunostaining to prove the lipid contents in neoplastic cells, which has the advantage of using formalin-fixed paraffin-embedded tissue and making needless frozen sections and ultrastructural studies to show these findings. Negative MDM2/CDK4 staining in our case argues against the possibility of dedifferentiated liposarcoma and further supports the diagnosis of true PL.
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Jose L
authors: JL
authors: Ramírez-Bellver
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Joaquín
authors: J
authors: López
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Elena
authors: E
authors: Macías
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Victoria
authors: V
authors: Alegría-Landa
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Ignacio
authors: I
authors: Gimeno
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Alejandra
authors: A
authors: Pérez-Plaza
authors: Department of Dermatology, Dermatopathologie Friedrichshafen, Friedrichshafen, Germany.
authors: Heinz
authors: H
authors: Kutzner
authors: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors: Luis
authors: L
authors: Requena
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D051358:Cyclin-Dependent Kinase 4 / Q000032:analysis / Q000096:biosynthesis; D006801:Humans; D007150:Immunohistochemistry; D008080:Liposarcoma / Q000175:diagnosis*; D008297:Male; D000070780:Perilipin-2 / Q000032:analysis / Q000096:biosynthesis*; D051736:Proto-Oncogene Proteins c-mdm2 / Q000032:analysis / Q000096:biosynthesis; D012878:Skin Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; C000602982:PLIN2 protein, human; D000070780:Perilipin-2; C497206:MDM2 protein, human; D051736:Proto-Oncogene Proteins c-mdm2; C495900:CDK4 protein, human; D051358:Cyclin-Dependent Kinase 4
keywords: MDM2/CDK4 gene amplification; adipophilin; cutaneous liposarcoma; liposarcoma; pleomorphic liposarcoma