Skip to main content

Well-Differentiated Mesenteric Liposarcoma with Osseous Metaplasia: A Potential Diagnostic Dilemma for the Pathologist

Journal of Gastrointestinal Cancer volume 41, pages 79–83 (2010)Cite this article

Abstract

Background

Mesenteric liposarcoma is a rare intra-abdominal sarcoma with very few cases reported in the available English literature. Incomplete resection of the tumor leads to recurrence, and recurrent tumors carry a risk of dedifferentiation. Dedifferentiation in liposarcoma manifests as a nonlipogenic sarcoma, which is usually high-grade and may show osteosarcomatous differentiation rarely. To the best of our knowledge, osteoid metaplasia in a well-differentiated liposarcoma without evidence of dedifferentiation has not been documented in the available literature.

Case

We describe the case of a middle-aged adult man with a well-differentiated liposarcoma of the mesentery. The patient presented with a recurrent tumor 5 years after the initial surgery. At recurrence, the histological features were those of a well-differentiated liposarcoma with focal osseous metaplasia without any evidence of dedifferentiation in the extensive sections examined.

Conclusion

Osseous metaplasia is a rare phenomenon in lipomas and dedifferentiated liposarcomas. Such an occurrence in a recurrent well-differentiated liposarcoma is a perplexing problem due to the potential confusion with dedifferentiation. This needs to be recognized to avoid overzealous chemotherapy and/or radiotherapy, which is required for dedifferentiated tumors.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Fletcher CDM, Unni KK, Mertens F. World Health Organization classification of tumors. Pathology and genetics of tumors of soft tissue and bone. Lyon: IARC; 2002. p. 227–32.

    Google Scholar 

  2. Ishiguro S, Yamamoto S, Chuman H, Moriya Y. A case of resected huge ileocolonic mesenteric liposarcoma which responded to pre-operative chemotherapy using doxorubicin, cisplatin and ifosfamide. Jpn J Clin Oncol. 2006;36:735–8.

    Article  PubMed  Google Scholar 

  3. Toms AP, White LM, Kandel R, Bell RS. Low-grade liposarcoma with osteosarcomatous dedifferentiation: radiological and histological features. Skeletal Radiol. 2003;32:286–9.

    PubMed  Google Scholar 

  4. Evans HL, Khurana KK, Kemp BL, Ayala AG. Heterologous elements in the dedifferentiated component of dedifferentiated liposarcoma. Am J Surg Pathol. 1994;18:1150–7.

    CAS  PubMed  Article  Google Scholar 

  5. Laurino L, Furlanetto A, Orvieto E, DelTos AP. Well-differentiated liposarcoma (atypical lipomatous tumors). Semin Diagn Pathol. 2001;18:258–62.

    CAS  PubMed  Google Scholar 

  6. Mendenhall WM, Zlotecki RA, Hochwald SN, Hemming AW, Grobmyer SR, Cance WG. Retroperitoneal soft tissue sarcoma. Cancer. 2005;104:669–75.

    Article  PubMed  Google Scholar 

  7. Winn B, Gao J, Akbari H, Bhattacharya B. Dedifferentiated liposarcoma arising from the sigmoid mesocolon. A case report. World J Gastroenterol. 2007;13:4147–8.

    PubMed  Google Scholar 

  8. Goel AK, Sinha S, Kumar A, Karak AK, Chattopadhyay TK. Liposarcoma of the mesocolon—case report of a rare lesion. Surg Today. 1994;24:1003–6.

    Article  CAS  PubMed  Google Scholar 

  9. Nakamura A, Tanaka S, Takayama H, Sakamoto M, Ishii H, Kusano M, et al. A mesenteric liposarcoma with production of granulocyte colony-stimulating factor. Intern Med. 1998;37:884–90.

    Article  CAS  PubMed  Google Scholar 

  10. Kim T. CT and MR imaging of abdominal liposarcoma. AJR Am J Roentgenol. 1996;166:829–33.

    CAS  PubMed  Google Scholar 

  11. Hirakoba M, Kume K, Yamasaki M, Kanda K, Yoshikawa I, Otsuki M. Primary mesenteric liposarcoma successfully diagnosed by pre-operative imaging studies. Intern Med. 2007;46:373–5.

    Article  PubMed  Google Scholar 

  12. Goldblum JR, Weiss SW. Enzinger and Weiss' soft tissue tumors. St. Louis: Mosby; 2001. p. 641–93.

    Google Scholar 

  13. Mackenzie IR, Girvin JP, Lee D. Symptomatic osteolipoma of the tuber cinereum. Clin Neuropathol. 1996;15:60–2.

    CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

    Ruchika Gupta, Alok Sharma, Raman Arora & Manoj K. Singh

  2. Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India

    Mukund P. Kulkarni & T. K. Chattopadhaya

  3. 162, Pocket-B, Sarita Vihar, New Delhi, 110076, India

    Ruchika Gupta

Authors
  1. Ruchika Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alok Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raman Arora
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mukund P. Kulkarni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. K. Chattopadhaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manoj K. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ruchika Gupta.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gupta, R., Sharma, A., Arora, R. et al. Well-Differentiated Mesenteric Liposarcoma with Osseous Metaplasia: A Potential Diagnostic Dilemma for the Pathologist. J Gastrointest Canc 41, 79–83 (2010). https://doi.org/10.1007/s12029-009-9119-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12029-009-9119-2

Keywords

  • liposarcoma
  • mesenteric
  • well-differentiated
  • osseous metaplasia
  • diagnosis