Synchronous Renal Dedifferentiated Liposarcoma and Retroperitoneal Well-Differentiated Liposarcoma: A Case Report With Literature Review

2020 ◽  
pp. 106689692098168
Author(s):  
Ling Nie ◽  
Xueqin Chen ◽  
Jing Gong ◽  
Mengni Zhang ◽  
Miao Xu ◽  
...  
Keyword(s):  
Left Kidney ◽  
Final Diagnosis ◽  
Dedifferentiated Liposarcoma ◽  
Pathological Examination ◽  
Retroperitoneal Mass ◽  
Mdm2 Gene ◽  
Contrast Enhanced ◽  
High Grade Sarcoma ◽  
Well Differentiated ◽  
Enhanced Computed Tomography

Liposarcoma is the most common soft tissue malignancy and usually occurs in the retroperitoneum or the extremities but rarely in the kidney. In this article, we report a case of a 71-year-old female patient who presented with abdominal lump and left flank pain for 1 month. An abdominal contrast-enhanced computed tomography scan demonstrated a 12 cm × 7 cm solid mass arising from the upper pole of left kidney and another 8 cm × 6 cm low-density retroperitoneal mass with fat density. Radical nephrectomy of the left kidney and resection of the retroperitoneal mass were performed. Surprisingly, pathological examination revealed a high-grade sarcoma (with minor lipomatous component) in the left kidney and a retroperitoneal well-differentiated liposarcoma. MDM2 gene amplification was identified by fluorescence in situ hybridization in both tumors, supporting final diagnosis of dedifferentiated liposarcoma of the kidney and well-differentiated liposarcoma of the retroperitoneum.

scholarly journals A rare oesophageal inflammatory myofibroblastic tumour treated by endoscopy

2018 ◽  
Vol 100 (4) ◽  
pp. e66-e68
Author(s):  
ZY Fang ◽  
HX Huang ◽  
C Lu ◽  
XX Zhou ◽  
F Ji ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Final Diagnosis ◽  
Pathological Examination ◽  
Inflammatory Myofibroblastic Tumour ◽  
Poor Appetite ◽  
Contrast Enhanced ◽  
Mesenchymal Neoplasm ◽  
Oesophageal Tumour ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

An inflammatory myofibroblastic tumour is a mesenchymal neoplasm that mostly involves the lung and rarely involves the oesophagus. Surgery has been most commonly used for the treatment of oesophageal inflammatory myofibroblastic tumours but there are no definite guidelines for their diagnosis and treatment. We describe the case of a 60-year-old woman presenting with dysphagia and poor appetite who was diagnosed with a submucosal oesophageal tumour by contrast enhanced computed tomography and ultrasonography endoscopy. She was treated successfully by endoscopic submucosal dissection with no complications. The final diagnosis was confirmed by pathological examination.

scholarly journals Hepatic Epithelioid Hemangioendothelioma Presenting Synchronously with Hepatocellular Carcinoma

2021 ◽  
pp. 344-351
Author(s):  
Hiroki Kanno ◽  
Toshihiro Sato ◽  
Ryuta Midorikawa ◽  
Satoki Kojima ◽  
Shogo Fukutomi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Carbohydrate Antigen ◽  
Epithelioid Hemangioendothelioma ◽  
Arterial Phase ◽  
Rapid Progression ◽  
Imaging Findings ◽  
Liver Segment ◽  
Contrast Enhanced ◽  
Well Differentiated ◽  
Enhanced Computed Tomography

Hepatic epithelioid hemangioendothelioma (EHE) is a rare malignant tumor with unknown pathogenesis. Herein, we report a case of a hepatic EHE presenting synchronously with a hepatocellular carcinoma (HCC). To the best of our knowledge, this is the second case report of synchronous hepatic EHE and HCC. An 84-year-old man presented with back pain. During examination, a tumor in liver segment 3 was coincidentally detected. Tumor marker (carbohydrate antigen 19-9, alpha-fetoprotein, and protein induced by vitamin K absence or antagonist-II) levels were elevated. Contrast-enhanced computed tomography revealed perinodular enhancement in the arterial and portal phases. Another tumor was detected in liver segment 2, which was homogeneously enhanced in the arterial phase, followed by washout in the portal and late phases. Based on these imaging findings, we diagnosed the tumor in segment 3 as a solitary cholangiocellular carcinoma and the tumor in segment 2 as a solitary HCC. Lateral sectionectomy of the liver was performed. Microscopically, spindle-shaped and epithelioid cells were present in the tumor in segment 3. On immunohistochemistry, the tumor cells were positive for CD31 and CD34, focally positive for D2-40, and negative for AE1/AE3. Therefore, the tumor in segment 3 was ultimately diagnosed as an EHE and the tumor in segment 2 as a well-differentiated HCC. Preoperative diagnosis of EHE is difficult owing to the lack of specific findings. Intratumoral calcification, halo sign, and lollipop sign are occasionally found in EHE and are useful imaging findings for diagnosis. Clinical behavior is unpredictable, ranging from indolent growth to rapid progression. Clinical or pathological predictors of the course of EHE are urgently required.

scholarly journals Myxoid liposarcoma of small bowel presenting with intussusception and obstruction: A case report

2022 ◽  
pp. 519-521
Author(s):  
Mohd Monis ◽  
Divyashree Koppal ◽  
Aiman Ibbrahim ◽  
Zeeshan Nahid
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Leading Edge ◽  
Surgical Excision ◽  
Myxoid Liposarcoma ◽  
Histopathological Analysis ◽  
Contrast Enhanced ◽  
Well Differentiated ◽  
Enhanced Computed Tomography

Gastrointestinal liposarcomas are extremely rare with the most common reported morphological subtype being dedifferentiated liposarcoma and well-differentiated liposarcoma. These tumors are rarely diagnosed preoperatively and diagnosis is only confirmed on histopathological analysis. Treatment of gastrointestinal liposarcomas consists of surgical excision with widely negative margins followed by post-operative irradiation and close follow-up. We report an exceedingly rare case of myxoid liposarcoma of the small bowel (ileum) presenting with an unusual presentation with intussusception and intestinal obstruction. A 42-year-old male presented to the emergency department with features of intestinal obstruction. Contrast-enhanced computed tomography abdomen revealed ileo-ileal intussusception with an endoluminal soft-tissue lesion at the leading edge. The patient was taken for surgical intervention and the involved segment of the bowel along with the lesion was resected and re-anastomosis done. Histological sections of the mass along with immunohistochemistry suggested the pathological diagnosis of myxoid liposarcoma.

scholarly journals Gigantic kidney tumour presenting with weight gain

2019 ◽  
Vol 6 (11) ◽  
pp. 4181
Author(s):  
Balaji Chandhirasekar ◽  
Sushanto Neogi ◽  
Manu Vats ◽  
Vineet Kumar Pandey
Keyword(s):  
Computed Tomography ◽  
Renal Mass ◽  
Left Kidney ◽  
Papillary Renal Cell Carcinoma ◽  
En Bloc ◽  
Kidney Tumour ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Open Nephrectomy ◽  
Contrast Enhanced Computed Tomography

A 61 years obese gentleman presented early with gain of weight and lump in the left side of abdomen for 15 days. On contrast enhanced computed tomography (CECT) of abdomen, a giant renal mass arising from left kidney. Patient underwent open nephrectomy, surgically removed en bloc of 12.5 kg weight largest renal mass. Histopathology showed papillary renal cell carcinoma. The postoperative period was uneventful.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

scholarly journals Retroperitoneal paraganglioma: a chameleon masquerading as an adrenal pheochromocytoma

2019 ◽  
Vol 101 (2) ◽  
pp. e62-e65 ◽  
Author(s):  
K Parmar ◽  
A Chandna ◽  
S Kumar
Keyword(s):  
Vena Cava ◽  
Final Diagnosis ◽  
Contrast Enhanced ◽  
Rare Tumours ◽  
Close Proximity ◽  
Adrenal Pheochromocytoma ◽  
Suprarenal Mass ◽  
One Year ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Retroperitoneal paragangliomas are rare tumours arising from neural crest cells located near or in the autonomic nervous system; right from the skull bass to the pelvic floor. Often called the great masqueraders, their diagnosis and treatment is often difficult and fraught with danger, considering the close proximity of these tumours to important retroperitoneal organs. A 29-year-old woman presented to the outpatient department with complaints of paroxysms of headache, sweating and palpitations for one year. She was found to have elevated urinary metadrenalines (metanephrines) and a suprarenal mass on contrast-enhanced computed tomography of the abdomen, which demonstrated increased tracer activity on I-131 iodine-123 meta-iodobenzylguanidine scintigraphy. Adrenal pheochromocytoma was diagnosed and she underwent laparoscopic adrenalectomy after stabilisation of her blood pressure. Laparoscopy revealed a large suprarenal mass with dense adhesions to the inferior vena cava that was carefully separated from the vein and surrounding structures. The cut section revealed a heterogeneous mass encasing a normal adrenal gland and histopathology confirmed the same, confirming the final diagnosis of retroperitoneal paraganglioma.

scholarly journals Giant Renal Angiomyolipoma: Unusual Cause of Huge Abdominal Mass

2013 ◽  
Vol 3 ◽  
pp. 56 ◽  
Author(s):  
Rajesh Taneja ◽  
Dig Vijay Singh
Keyword(s):  
Abdominal Mass ◽  
Left Kidney ◽  
Histochemical Staining ◽  
Renal Angiomyolipoma ◽  
Abdominal Girth ◽  
Surgical Specimen ◽  
Contrast Enhanced ◽  
Giant Tumor ◽  
Cect Scan ◽  
Enhanced Computed Tomography

We present the imaging and histopathological characteristics of a giant renal angiomyolipoma (AML) in a 49-year-old female patient, who presented with bloating sensation in the abdomen and a steadily increasing abdominal girth for about 3 years. Contrast enhanced computed tomography (CECT) scan films of abdomen revealed that a large fat containing tumor had replaced the left kidney while displacing the rest of the abdominal contents toward the other side of the midline. Intraoperatively the left kidney was completely replaced by a fat containing tumor. The recovered surgical specimen measured 39 cm × 25 cm × 9 cm and weighed 7500 g. Histopathological investigation with immuno-histochemical staining of the specimen with hydroxy beta-methylbutyric acid-45 confirmed this lesion as AML. CECT scan of the head did not show any lesion suggestive of tuberous sclerosis. The giant tumor of the present case is the heaviest AML in both syndromic and sporadic categories and largest by dimensions as sporadic AML ever reported in the literature.

scholarly journals Diagnostic evaluation of congenital respiratory stridor in children

New Medicine ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Monika Jabłońska-Jesionowska ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Respiratory Tract ◽  
General Anaesthesia ◽  
Lower Respiratory Tract ◽  
Final Diagnosis ◽  
Diagnostic Evaluation ◽  
Radiographic Examination ◽  
Common Cause ◽  
Contrast Enhanced ◽  
The Right ◽  
Enhanced Computed Tomography

Introduction. Congenital respiratory stridor in children is the result of respiratory tract pathology located at various anatomical levels. There is an ongoing debate on whether every case of stridor requires diagnostic evaluation and which method is the most effective for determining the final diagnosis. Aim. The aim of the present study is to answer the question which procedure should be performed to diagnose the casuse of congenital stridor in children and why, and what the most common cause of the stridor is. Material and methods. A group of 110 children examined due to congenital respiratory stridor was analysed. The children’s general condition was assessed and imaging studies and lower respiratory tract endoscopy were performed under general anaesthesia. In some children cardiac ultrasound and contrast-enhanced radiographic examination of the oesophagus or contrast-enhanced computed tomography scan of the chest were performed. Results. Children aged 3 days to 11 years were analysed. The most common cause of stridor was congenital laryngeal hypotonia found in 50% of children and the second most common was abnormalities of the great arteries in 28% of children. Biphasic stridor, which may be a sign of multiple respiratory abnormalities, was diagnosed most frequently. It was only lower respiratory tract endoscopy performed under general anaesthesia that made it possible to make the right diagnosis. Conclusions. The most useful diagnostic method for congenital respiratory stridor is lower respiratory tract endoscopy under general anaesthesia, which is used to evaluate both the larynx and the trachea since defects may coexist at various respiratory levels. It is also for this reason that the type of stridor is not tantamount to the level at which the pathology is located in the respiratory tract. One needs to bear in mind that abnormalities of the great arteries may also be the cause of congenital respiratory stridor.

scholarly journals Primary Intraparenchymal Squamous Cell Carcinoma of the Kidney: A Rare and Unique Entity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Prithwijit Ghosh ◽  
Kaushik Saha
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Renal Parenchyma ◽  
Contrast Enhanced ◽  
Well Differentiated ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Upper Abdomen ◽  
Contrast Enhanced Computed Tomography

Primary squamous cell carcinoma (SCC) of the renal parenchyma is a very unusual entity which needs to be differentiated from primary SCC of renal pelvis, SCC from another primary site, and urothelial carcinoma with extensive squamous differentiation. We are most probably describing the second case of primary SCC of the renal parenchyma in a 51-year-old male who presented with heaviness of right upper abdomen with intermittent pain in right flank. Contrast-enhanced computed tomography (CECT) revealed a mass in the right lower pole of the kidney and histopathology following nephrectomy displayed the features of well-differentiated squamous cell carcinoma without urothelial involvement.

scholarly journals Osteosarcomatous Divergence in Dedifferentiated Liposarcoma Presenting as a Colonic Mass

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Jeenal Gordhandas ◽  
Grace Lin ◽  
Ann M. P. Tipps ◽  
Somaye Y. Zare
Keyword(s):  
Rare Case ◽  
Dedifferentiated Liposarcoma ◽  
High Grade ◽  
Mdm2 Gene ◽  
Atypical Cells ◽  
Well Differentiated ◽  
High Level ◽  
Immunohistochemical Studies ◽  
Diffuse Positivity

Dedifferentiated liposarcomas most commonly arise in the retroperitoneum, accounting for 10% of liposarcomas. Heterologous differentiation occurs in 5-10% of dedifferentiated liposarcomas; however, divergent osteosarcomatous differentiation is rare. We report a rare case of initial presentation of dedifferentiated liposarcoma with osteosarcomatous component as a colonic mass in a 72-year-old man. The tumor is mainly composed of bony trabeculae with intervening highly atypical cells and adjacent high-grade mesenchymal nonlipogenic tumor, as well as areas of well-differentiated liposarcoma. Immunohistochemical studies showed diffuse positivity for SATB2 in the atypical cells and fluorescence in situ hybridization revealed high-level amplification of MDM2 gene, supporting the diagnosis of well-differentiated and dedifferentiated liposarcoma with heterologous osteosarcomatous differentiation.

Sign in / Sign up

Export Citation Format

Share Document