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Paraneoplastic Syndrome Associated with the Retroperitoneal Dedifferentiated Liposarcoma: an Atypical Presentation and Review of the Literature

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Abstract

Retroperitoneal liposarcoma is usually asymptomatic until it is large enough to compress the surrounding organs. Here, we report a rare atypical case of primary retroperitoneal dedifferentiated liposarcoma who presented primarily with the misguiding and challenging paraneoplastic symptoms of high-grade fever and thrombocytosis instead of demonstrating the usual compressive symptoms. Such an extremely rare clinical presentation may mislead the diagnostic and treatment approach towards the search for medical causes, without a hint, that the tumor itself is causing these symptoms. Complete tumor excision usually leads to resolution of these paraneoplastic symptoms.

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References

  1. Henry K (2019) Paraneoplastic syndromes: definitions, classification, pathophysiology and principles of treatment. Semin Diagn Pathol 36:204–210. https://doi.org/10.1053/j.semdp.2019.01.002

    Article  PubMed  Google Scholar 

  2. Zell JA, Chang JC (2005) Neoplastic fever: a neglected paraneoplastic syndrome. Support Care Cancer 13:870–877. https://doi.org/10.1007/s00520-005-0825-4

    Article  PubMed  Google Scholar 

  3. Lin RJ, Afshar-Kharghan V, Schafer AI (2014) Paraneoplastic thrombocytosis: the secrets of tumor self-promotion. Blood 124:184–187. https://doi.org/10.1182/blood-2014-03-562538

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kumar V, Misra S, Chaturvedi A (2012) Retroperitoneal sarcomas - a challenging problem. Indian J Surg Oncol 3:215–221. https://doi.org/10.1007/s13193-012-0152-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Fletcher CDM, Bridge JA, Hogendoorn PCWMF (2013) World Health Organization classification of tumours of soft tissue and bone, 4th edn. IARC Press, Lyon

    Google Scholar 

  6. Singer S, William DT, Crago AM, OB (2019) Soft tissue sarcoma. In: Devita VT Jr, Theodore SLRS (eds) Cancer – princ. pract. oncol, 11th edn. Lippincott Williams & Wilikins, Philadelphia, pp 2488–2572

    Google Scholar 

  7. Parmeggiani D, Avenia N, De Falco M, Bilancio G, Ruggero R, Docimo G et al (2010) Retroperitoneal dedifferentiated liposarcoma (DDLS) with hyperglycemic activity: case report and literature review. Minerva Chir 65:479–484

    CAS  PubMed  Google Scholar 

  8. Monma S, Adachi K, Hashimoto T, Ohshima A (2012) Granulocyte colony-stimulating factor expressing retroperitoneal dedifferentiated liposarcoma. Am Surg 78:375–376

    PubMed  Google Scholar 

  9. Maryamchik E, Lyapichev KA, Halliday B, Rosenberg AE (2018) Dedifferentiated liposarcoma with rhabdomyosarcomatous differentiation producing HCG: a case report of a diagnostic pitfall. Int J Surg Pathol 26:448–452. https://doi.org/10.1177/1066896918760192

    Article  PubMed  Google Scholar 

  10. Schöffski P, Sweldens C, Vanderbeeken M-C, Forceville K, Vandenbroucke J, Dubin M, Debiec-Rychter M, Wozniak A, Sciot R (2011) Retroperitoneal dedifferentiated liposarcomas with production of β-human chorionic gonadotropin – a distinct sarcoma entity? Onkologie 34:122–125. https://doi.org/10.1159/000324786

    Article  PubMed  Google Scholar 

  11. Nasser SM, Choudry UH, Nielsen GP, Ott MJ (2001) A leukemoid reaction in a patient with a dedifferentiated liposarcoma. Surgery 129:765–767. https://doi.org/10.1067/msy.2001.109498

    Article  CAS  PubMed  Google Scholar 

  12. Tartaglia F, Blasi S, Sgueglia M, Polichetti P, Tromba L, Berni A (2007) Retroperitoneal liposarcoma associated with small plaque parapsoriasis. World J Surg Oncol 5:76. https://doi.org/10.1186/1477-7819-5-76

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zhou L, Wei X, Wu N-W, Zhang H-M, Liao B-H, Chen S-L, Li H, Zhu YC, Wang KJ (2018) Paraneoplastic cerebellar degeneration associated with pelvic liposarcoma: a rare case report. Urol Int 100:364–367. https://doi.org/10.1159/000452167

    Article  PubMed  Google Scholar 

  14. Toyoda Y, Endo W, Kojima F, Matsunaga H, Shimizu K, Yoshioka A et al (2012) A case of liposarcoma of the abdominal wall complicated by thrombocytpenia as a paraneoplastic syndrome. Gan To Kagaku Ryoho 39:2420–2422

    PubMed  Google Scholar 

  15. Sherman JL, Liu EY, Ozao-Choy J, Winston JA, Lee J, Dikman SH, Divino CM (2010) Paraneoplastic glomerulopathy secondary to retroperitoneal sarcoma: a case report. J Surg Oncol 102:704–705. https://doi.org/10.1002/jso.21689

    Article  PubMed  Google Scholar 

  16. Kondo M, Mokuno K, Uemura A, Kachi S, Nakamura M, Kondo A et al (2010) Paraneoplastic retinopathy associated with retroperitoneal liposarcoma. Clin Ophthalmol 4:243–245

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chan JW (2007) Subacute complete ophthalmoplegia: an anti-Hu paraneoplastic manifestation of myxoid liposarcoma. Clin Exp Ophthalmol 35:491–492. https://doi.org/10.1111/j.1442-9071.2007.01522.x

    Article  PubMed  Google Scholar 

  18. Sator P-G, Breier F, Gschnait F (2006) Acrokeratosis paraneoplastica (Bazex’s syndrome): association with liposarcoma. J Am Acad Dermatol 55:1103–1105. https://doi.org/10.1016/J.JAAD.2006.05.064

    Article  PubMed  Google Scholar 

  19. Bosco M, Allia E, Coindre J-M, Odasso C, Pagani A, Pacchioni D (2006) α-Fetoprotein expression in a dedifferentiated liposarcoma. Virchows Arch 448:517–520. https://doi.org/10.1007/s00428-006-0151-3

    Article  PubMed  Google Scholar 

  20. des Guetz G, Mariani P, Freneaux P, Pouillart P (2004) Paraneoplastic syndromes in cancer. J Clin Oncol 22:2242–2243. https://doi.org/10.1200/JCO.2004.08.019

    Article  PubMed  Google Scholar 

  21. Nakamura A, Tanaka S, Takayama H, Sakamoto M, Ishii H, Kusano M et al (1998) A mesenteric liposarcoma with production of granulocyte colony-stimulating factor. Intern Med 37:884–890

    Article  CAS  PubMed  Google Scholar 

  22. Krunic AL, Kokai D, Bacetic B, Kesic V, Nikolic MM, Petkovic S, Clark RE (1997) Retroperitoneal round-cell liposarcoma associated with paraneoplastic pemphigus presenting as lichen planus pemphigoides-like eruption. Int J Dermatol 36:526–529

    Article  CAS  PubMed  Google Scholar 

  23. Callegaro D, Fiore M, Gronchi A (2015) Personalizing surgical margins in retroperitoneal sarcomas. Expert Rev Anticancer Ther 15:553–567. https://doi.org/10.1586/14737140.2015.1028375

    Article  CAS  PubMed  Google Scholar 

  24. Tseng WW, Madewell JE, Wei W, Somaiah N, Lazar AJ, Ghadimi MP, Hoffman A, Pisters PWT, Lev DC, Pollock RE (2014) Locoregional disease patterns in well-differentiated and dedifferentiated retroperitoneal Liposarcoma: implications for the extent of resection? Ann Surg Oncol 21:2136–2143. https://doi.org/10.1245/s10434-014-3643-4

    Article  PubMed  Google Scholar 

  25. Bonvalot S, Rivoire M, Castaing M, Stoeckle E, Le Cesne A, Blay JY et al (2009) Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 27:31–37. https://doi.org/10.1200/JCO.2008.18.0802

    Article  PubMed  Google Scholar 

  26. Gronchi A, Miceli R, Allard MA, Callegaro D, Le Péchoux C, Fiore M et al (2015) Personalizing the approach to retroperitoneal soft tissue sarcoma: histology-specific patterns of failure and postrelapse outcome after primary extended resection. Ann Surg Oncol 22:1447–1454. https://doi.org/10.1245/s10434-014-4130-7

    Article  PubMed  Google Scholar 

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Correspondence to Jeewan Ram Vishnoi.

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Vishnoi, J.R., Jain, A., Misra, S. et al. Paraneoplastic Syndrome Associated with the Retroperitoneal Dedifferentiated Liposarcoma: an Atypical Presentation and Review of the Literature. Indian J Surg Oncol 10, 703–707 (2019). https://doi.org/10.1007/s13193-019-00971-0

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