Case of a huge recurrent retroperitoneal liposarcoma diagnosed in the second trimester of pregnancy

We document a case of a 24-year-old gravida 2, para 1 (1001), on her second trimester, who was referred to the surgical oncology service for a palpable right hemiabdominal mass. She previously underwent wide excision of a retroperitoneal atypical lipomatous tumour 2 years ago. Her current case was successfully managed by a multidisciplinary team of doctors from the preoperative phase, the actual surgery up to the adjuvant treatment. She had a two-staged surgery: an elective lower-segment caesarean section at 34 weeks age of gestation for which she delivered a healthy baby girl and, 2 weeks after, she had excision of the huge retroperitoneal tumour recurrence. Histopathology revealed a 35 cm×25 cm×22 cm dedifferentiated liposarcoma, for which she was started on adjuvant systemic chemotherapy.

Atypical lipomatous tumor with osteoid metaplasia – a rare occurrence

The presence of metaplastic ossification within a atypical lipomatous tumour /well differentiated Liposarcoma (ALT/WDLPS) is a rare occurrence. We report a case ALT/WDLPS with unusual extensive metaplastic bone formation in a 30 years female who complained of swelling in the right shoulder for the past one and a half years. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.197-199

Surgical Excision of a rare cardiac tumour: Cardiac Hibernoma

We report a case of cardiac hibernoma, which is a very rare type of benign lipomatous tumour. They are usually asymptomatic and therefore remain undetected or are found incidentally. When symptomatic, they vary and depend on location of heart involved. The patient had a hibernoma on right atrial wall invading the intra-atrial groove and extending over superior vena cava (SVC), causing significant symptoms of SVC obstruction and tamponade. The patient therefore underwent emergency operation, in which the tumour was resected and the right atrium was reconstructed with Bovine pericardial patch. He was discharged home well.

A REVIEW ON LIPOMA AND ITS GENETIC INTERVENTIONS

Lipomas are benign soft tissue fatty tumours that most commonly appear in the third decade of life when fatty tissue accumulates. Histologically, lipoma is composed of mature fat cells with a thin fibrous capsule. Simple lipomas account for 80% of adipose tissue tumours. The aetiology may be genetic like Familial Multiple Lipomatosis. Some tumours, like the well differentiated Liposarcomas never metastasize unless they undergo de-differentiation. They can be introduced as Atypical Lipomatous Tissue, ALT. Southern blot analysis is performed by obtaining DNA from ALT, cases in which most of them are characterized by the presence of supernumerary ring and long marker chromosomes. The complex chromosome region contains genes MDM2, CDK4, HMGI- C, SAS, GLI, CHOP, OS4 and OSP. Most of ALTs, after analysis revealed amplification of CDK4 and MDM2 proto- oncogenes that play major role in permitting over ride of block operated on cell proliferation. Immuno-histochemical results have shown MDM2 over expression in about 50% of ALTs along with weak CDK4 immuno-positivity. Also the lipomas with Gene fusion transcripts have the expression of certain genes, HMGA2/LPP, HMGA2/RDCI and HMGA2/NFIB. Of these 98% of cases were analyzed for the possible expression of HMGA2/LPP and LPP- HMGA2 fusion genes using reverse transcription polymerase chain reaction. Over all these cases, shows non-enhanced adipocyte apoptosis and enhanced adipogenesis in lipoma tissue. Thus studies provide insights into molecular pathogenesis of lipomatous tumour and representation of distinctive subset of mesenchymal neoplasms with mature adipocyte differentiation.