scholarly journals Dedifferentiated liposarcoma with abrupt transition of low-grade and high-grade dedifferentiated components: A case report

2021 ◽  
Author(s):  
YANG WEN ◽  
XIANGLEI HE ◽  
MING ZHAO
Keyword(s):  
Abdominal Mass ◽  
Dedifferentiated Liposarcoma ◽  
Fish Analysis ◽  
Low Grade ◽  
High Grade ◽  
Sharp Transition ◽  
Mdm2 Gene ◽  
Magnetic Resonance Imaging Mri ◽  
Histological Heterogeneity ◽  
Histological Morphology

Abstract BackgroundDedifferentiated liposarcoma (DDLPS) is a unique subtype of liposarcoma, which has obvious histological heterogeneity. In affected patients, the condition typically manifests as the dedifferentiation of high-grade histological morphology, but it may also manifest as the dedifferentiation of low-grade histological morphology. In some cases, unique histological or immunophenotypic characteristics are observed. We describe, herein, a rare case of dedifferentiated liposarcoma, in which the high-grade and low-grade dedifferentiated components coexisted with a relatively sharp transition in pathology.Case presentationA 69-year-old woman with severe abdominal pain lasting for 1 hour presented to our hospital. Physical examination revealed a mobile large left abdominal mass, Magnetic resonance imaging (MRI) scan showed a huge mass with typical fat components and the non-fatty nodule in the left retroperitoneal cavity. After laparotomy, histologic analysis of the specimens could find the atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS) and DDLPS components. Fluorescence in situ hybridization (FISH) analysis suggested the presence of MDM2 gene amplification. These findings supported a diagnosis of DDLPS.ConclusionIn our case, the high-grade and low-grade dedifferentiated components coexisted with a relatively sharp transition in pathology. We hypothesize that low-grade dedifferentiation may be a precursor to high-grade dedifferentiation. MRI images cannot distinguish the two components.

scholarly journals Dedifferentiated Liposarcoma with Abrupt Transition of Low-Grade and High-Grade Dedifferentiated Components ：A Case Report

2020 ◽  
Author(s):  
YANG WEN ◽  
XIANGLEI HE ◽  
MING ZHAO
Keyword(s):  
Abdominal Mass ◽  
Dedifferentiated Liposarcoma ◽  
Fish Analysis ◽  
Low Grade ◽  
High Grade ◽  
Sharp Transition ◽  
Mdm2 Gene ◽  
Magnetic Resonance Imaging Mri ◽  
Histological Heterogeneity ◽  
Histological Morphology

Abstract Background: Dedifferentiated liposarcoma (DDLPS) is a unique subtype ofliposarcoma, which has obvious histological heterogeneity. In affected patients, the condition typically manifests as the dedifferentiation of high-grade histological morphology, but it may also manifest as the dedifferentiation of low-grade histological morphology. In some cases, unique histological or immunophenotypic characteristics are observed. We describe, herein, a rare case of dedifferentiated liposarcoma, in which the high-grade and low-grade dedifferentiated components coexisted with a relatively sharp transition in pathology.Case presentation: A 69-year-old woman with severe abdominal pain lasting for 1 hour presented to our hospital. Physical examination revealed a mobile large left abdominal mass, Magnetic resonance imaging (MRI) scan showed a huge mass with typical fat components and the non-fatty nodule in the left retroperitoneal cavity. After laparotomy, histologic analysis of the specimens could find the ALT/WDLPS and DDLPS components. Fluorescence in situ hybridization (FISH) analysis suggested the presence of MDM2 gene amplification. These findings supported a diagnosis of DDLPS.Conclusion: In our case, the high-grade and low-grade dedifferentiated components coexisted with a relatively sharp transition in pathology. We hypothesize that low-grade dedifferentiation may be a precursor to high-grade dedifferentiation. MRI images cannot distinguish the two components.

scholarly journals Borderline Sign of A Rare Dedifferentiated Liposarcoma: Report of A Case

2020 ◽  
Author(s):  
Yang Wen ◽  
Songhua Fang ◽  
Ming Zhao ◽  
Xianglei He
Keyword(s):  
Abdominal Mass ◽  
Tumor Resection ◽  
Dedifferentiated Liposarcoma ◽  
Resected Specimen ◽  
Fish Analysis ◽  
Low Grade ◽  
High Grade ◽  
Mdm2 Gene ◽  
Rare Type ◽  
Histological Morphology

Abstract Background: Dedifferentiated liposarcoma (DDLPS) is a unique subtype of liposarcoma, which has obvious histological heterogeneity. Most of them manifested as the dedifferentiation of high-grade histological morphology, but a few could be the dedifferentiation of low-grade histological morphology, or present as some special types of histological or immunophenotypic characteristics. We describe, herein, a case of rare type of dedifferentiated liposarcoma, in which the dedifferentiated components are high-grade and low-grade coexisting with a relatively sharp transition.Case presentation: A 69-year-old woman with severe abdominal pain lasting for 1 hour presented to our hospital. Physical examination revealed a mobile large left abdominal mass, which was shown on abdominal CT and MRI as a huge retroperitoneal tumor with lipogenic component and solid nonlipogenic components. Tumor resection was performed. Gross examination of the resected specimen showed the gray yellow fatty mass and a round like solid nodule adjacent to the fatty mass, the cut surface of the nodule was gray-white or fish flesh color, and gray yellow in the nodular center. Microscopic examination demonstrated the tumor contains the well-differentiated liposarcoma (WDLPS) component and the DDLPS component. The latter was composed of coexisting high-grade and low-grade components in which multiple focal regions of a sudden transition between the high-grade and the low-grade dedifferentiated component were identified. Immunohistochemistry showed that P16, CDK4, and MDM2 were diffusely positive. The FISH analysis revealed the presence of MDM2 gene amplification in the nuclei of the atypical cells. A final diagnosis of DDLPS was rendered.Conclusion: In our case, the borderline sign between the high-grade and low-grade dedifferentiated components in the histology may indicate that there can be obvious differentiation lines in tumor dedifferentiation, which is classically and typically abrupt. Low-grade dedifferentiation may be a precursor lesion of high-grade dedifferentiation. MRI images cannot distinguish the two components.

scholarly journals Dedifferentiated liposarcoma with abrupt transition of low-grade and high-grade dedifferentiation: A rare case report

2021 ◽  
Vol 35 ◽  
pp. 205873842110485
Author(s):  
Yang Wen ◽  
Xianglei He ◽  
Ming Zhao
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Dedifferentiated Liposarcoma ◽  
Low Grade ◽  
High Grade ◽  
Sharp Transition ◽  
Abrupt Transition ◽  
Rare Case Report ◽  
Histological Heterogeneity ◽  
Histological Morphology

Dedifferentiated liposarcoma is a unique subtype of liposarcoma, which has obvious histological heterogeneity. In affected patients, the condition typically manifests as the dedifferentiation of high-grade histological morphology, but it may also manifest as the dedifferentiation of low-grade histological morphology. In some cases, unique histological or immunophenotypic characteristics are observed. We describe, herein, a rare case of dedifferentiated liposarcoma, in which the high-grade and low-grade dedifferentiated components coexisted with a relatively sharp transition in pathology.

Ability of urovysion FISH analysis to select patients with low- or intermediate-risk non-muscle-invasive bladder cancer (LI-NMIBC) for decreased surveillance.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 283-283
Author(s):  
H. M. Rosevear ◽  
A. J. Lightfoot ◽  
M. A. O'Donnell
Keyword(s):  
First Year ◽  
Fish Analysis ◽  
Low Grade ◽  
High Grade ◽  
Genetic Changes ◽  
Screening Intervals ◽  
Muscle Invasive ◽  
Initial Resection

283 Background: Recurrent LI-NMIBC is difficult to detect cytologically, requiring frequent cystoscopies. Urovysion's (Abbot Laboratories, Downers Grove, IL) fluorescent in situ hybridization assay (FISH) detects genetic changes associated with LI-NMIBC and may be useful in identifying patients for extended screening intervals. Methods: Charts of 54 consecutive patients with LI-NMIBC who underwent cystoscopy, cytology, and FISH analysis every 3 months for the first year after resection since 2004 were retrospectively identified and reviewed. We analyzed the number of tumors or high-grade cytologies that would have been missed if surveillance cystoscopy, cytology, and FISH analysis had not been done between 3 and 12 months post-resection for patients with a normal cystoscopy, cytology, and FISH analysis at 3 months after initial resection and compared those results to patients with normal cystoscopy, cytology, and abnormal FISH analysis. Results: Mean age of the 54 patients was 67 (range 25–89) and 41 were males. Thirty-nine patients had normal cystoscopy, cytology, and FISH analysis at 3-months follow-up. If no further surveillance was done until 1 year post-resection, 2 low-grade tumors (3 and 7 mm at 7 months post-resection) and 2 incidents of high-grade cytology would have been missed (4 of 39, 10%). Fifteen patients had normal cystoscopy and cytology but abnormal FISH analysis results at 3 months. If no further surveillance had been done until 1 year after resection, 6 tumors (6 of 15, 40%) (5, 8, 3, 3, 9, 2 mm at 5, 6, 6, 7, 9, 10 months post-resection) and no high-grade cytology would have been missed. Overall, statistically fewer patients with normal compared to abnormal FISH analysis at first follow-up developed tumors before 1 year (4 of 39 vs. 6 of 15, p=0.033). Conclusions: FISH analysis can be used to significantly increase our ability to select patients suitable for extended screening intervals. It may be prudent to include FISH analysis at the first post-resection follow-up before selecting patients with LI-NMIBC for an extended screening interval. [Table: see text]

The Role of Pre-operative MRI For Prediction of High-Grade Intracranial Meningioma: A Retrospective Study

2021 ◽  
Author(s):  
Vitit Lekhavat ◽  
Kan Radeesri
Keyword(s):  
Clinical Outcomes ◽  
Histological Grade ◽  
Intracranial Meningioma ◽  
Low Grade ◽  
High Grade ◽  
Who Grade ◽  
Intracranial Meningiomas ◽  
Mri Features ◽  
Peritumoral Brain Edema ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction: High histological grade (WHO grade II and III) intracranial meningiomas have been linked to greater risk for tumor recurrence and worse clinical outcomes compared to low-grade (WHO grade I) tumors. Preoperative magnetic resonance imaging (MRI) plays a crucial role tumor evaluation prior to decisions regarding management and allows for a better understanding of the tumor grading, which could potentially alter clinical outcomes. The present study sought to determine whether preoperative MRI features of intracranial meningiomas can serve as predictors of high-grade tumors.Methods: This study retrospectively reviewed 327 confirmed cases of intracranial meningiomas, among whom 210 (64.2%) had available preoperative MRI studies. Thereafter, data were analyzed using univariate and multivariate analyses.Results: Accordingly, multivariate analysis found that peritumoral brain edema and the presence of necrosis or hemorrhage were predictors of high-grade tumors, whereas hyperostosis was a predictor of low-grade tumors.Conclusions: Our study suggested that preoperative MRI features could potentially assist in decision-making regarding the appropriate management and surgical approach in order to achieve the desired clinical outcomes.

scholarly journals Giant Retroperitoneal Mucinous Tumor Supportively Diagnosed as a Dedifferentiated Liposarcoma by Fluorescence In Situ Hybridization of MDM2 Gene

ISRN Urology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Taku Naiki ◽  
Shuzo Hamamoto ◽  
Noriyasu Kawai ◽  
Aya Naiki-Ito ◽  
Yoshiyuki Kojima ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Fluorescence In Situ Hybridization ◽  
Therapeutic Strategy ◽  
Dedifferentiated Liposarcoma ◽  
Fish Analysis ◽  
Mdm2 Gene ◽  
Double Minute ◽  
Murine Double Minute

Surgical resection was performed on a 47-year-old woman for a retroperitoneal mass that weighed 8.5 kg. Histological examination revealed a myxoid sarcomatous tumor. Because diagnosis could not be determined by immunohistochemistry, attention was focused on MDM2 (murine double minute) gene amplification by fluorescence in situ hybridization (FISH) analysis. The tumor was finally determined to be a dedifferentiated liposarcoma. We experienced a case of a giant retroperitoneal dedifferentiated liposarcoma. FISH analysis was useful for the diagnosis and determination of the therapeutic strategy.

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.

Dedifferentiated Liposarcoma of Retroperitoneum With Extensive Osteosarcomatous Component

2016 ◽  
Vol 101 (5-6) ◽  
pp. 217-221 ◽  
Author(s):  
Claudia Trombatore ◽  
Caltabiano Rosario ◽  
Li Destri Giovanni ◽  
Magro Gaetano ◽  
Petrillo Giuseppe ◽  
...  
Keyword(s):  
Abdominal Mass ◽  
Dedifferentiated Liposarcoma ◽  
Caucasian Woman ◽  
High Grade ◽  
Retroperitoneal Mass ◽  
Tissue Component ◽  
Pleomorphic Sarcoma ◽  
Well Differentiated ◽  
High Grade Osteosarcoma ◽  
Tomography Scan

Dedifferentiated liposarcoma (DDLS) is a rare subtype of liposarcoma composed of 2 components: a well-differentiated liposarcoma (WDLS) and a nonlipogenic sarcoma (dedifferentiation component), represented in >90% of cases by a high grade undifferentiated pleomorphic sarcoma, in the form of both small microscopic foci and/or grossly recognizable nodular masses. The paper reports a rare case of a retroperitoneal DDLS, in which approximately half of a tumor mass is composed of a high-grade osteosarcoma. A 68-year-old Caucasian woman affected by abdominal discomfort. Clinical examination showed a large, hard and fixed abdominal mass. Computed tomography scan revealed a huge retroperitoneal mass composed of 2 distinct components: the upper part showed a hypodense tissue, while the lower part showed a higher density and coarse calcifications. Patient underwent to a challenging surgical resection of the mass that, at histological examination, resulted to be a DDLS, in which a WDLS coexisted with an osteosarcoma. Presurgical diagnosis of DDLS is difficult due to the great morphologic variability of the dedifferentiated component, ranging from low to high-grade nonlipogenic sarcoma. The present case contributes to widen the morphological spectrum of DDLS, emphasizing the possibility that a retroperitoneal mass with a dual tissue component, one of which containing extensive areas with coarse calcifications, is highly suspected to be a DDLS with an osteosarcomatous component. This pre-operative finding should alert the surgeon because it has a significant impact on prognosis, increasing the risk of local recurrence and of death by disease in a few months after diagnosis.

GENE EXPRESSION ANALYSIS OF A DEDIFFERENTIATED LIPOSARCOMA — DIFFERENCES BETWEEN HIGH AND LOW GRADE AREAS: ANALYSIS OF TWO CASES AND LITERATURE REVIEW

2005 ◽  
Vol 09 (01) ◽  
pp. 9-20 ◽  
Author(s):  
Meera R. Hameed ◽  
Tao-Zhen Lin ◽  
Frederick Coffman ◽  
Marion C. Cohen ◽  
Helen Fernandes ◽  
...  
Keyword(s):  
Differentially Expressed Genes ◽  
Expression Patterns ◽  
Soft Tissue Sarcomas ◽  
Differentially Expressed ◽  
Dedifferentiated Liposarcoma ◽  
Biological Behavior ◽  
Low Grade ◽  
High Grade ◽  
High Grade Sarcoma ◽  
Well Differentiated

The phenomenon of dedifferentiation typically occurs in soft tissue sarcomas where a low grade or well-differentiated tumor shows an abrupt transformation to a high-grade sarcoma without lineage specificity. The biological behavior and metastatic potential of these tumors is dictated by the dedifferentiated phenotype. Tumor material was available from two dedifferentiated liposarcomas. We performed cDNA microarray analysis of a dedifferentiated liposarcoma in which the atypical lipomatous/well-differentiated and dedifferentiated portions were grossly distinct, to find differentially expressed genes in the dedifferentiated component compared to the well-differentiated component. There were 100 differentially expressed genes, both up- and down-regulated in the high grade sarcoma. In addition, we performed RT-PCR on selected genes in both cases to confirm the microarray findings. We discuss the expression patterns of these genes in comparison to other studies in the literature.

Salivary Gland Secretory Carcinoma With High-Grade Transformation, CDKN2A/B Loss, Distant Metastasis, and Lack of Sustained Response to Crizotinib

2017 ◽  
Vol 25 (7) ◽  
pp. 613-618 ◽  
Author(s):  
Nicole A. Cipriani ◽  
Elizabeth A. Blair ◽  
Joshua Finkle ◽  
Jennifer L. Kraninger ◽  
Christopher M. Straus ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Molecular Genetic ◽  
Low Grade ◽  
High Grade ◽  
Secretory Carcinoma ◽  
Parotid Duct ◽  
Pleural Metastases ◽  
High Grade Transformation ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background. Salivary gland secretory carcinoma is usually a low-grade neoplasm. However, high-grade transformation can occur and has important implications for clinical outcome. Methods. A patient presented with an enlarging buccal mass. Magnetic resonance imaging (MRI) showed a tumor with a biphasic appearance along the right parotid duct. Local excision and histopathologic examination confirmed the diagnosis of secretory carcinoma with high-grade transformation. ETV6-NTRK3 translocation and loss of CDKN2A/B were identified. Results. The patient subsequently presented with cough and dyspnea and was found to have pleural metastases. Carboplatin and paclitaxel exacerbated the symptoms. Crizotinib resulted in initial symptomatic and radiographic improvement; however, the patient soon succumbed to progressive intrathoracic disease. Conclusions. High-grade salivary gland secretory carcinoma can have a biphasic appearance on MRI. Diagnosis is confirmed by the histologic appearance and associated ETV6-NTRK3 fusion. Additional molecular genetic events leading to transformation are unknown; however, loss of CDKN2A/B may have contributed. Treatment with multimodal chemotherapy was of limited benefit.

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