Skip to main content

Advertisement

SpringerLink
Log in

An oncologic emergency case of massive dedifferentiated liposarcoma of the small bowel mesentery

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

We report the case of a 71-year-old man who complained of abdominal distension, pedal edema, respiratory discomfort, and weight gain. Computed tomography revealed a giant, poorly enhancing tumor occupying the entire abdomen, with abdominal ascites. The tumor was causing hydronephrosis, compression of the inferior vena cava, and elevation of the diaphragm. The patient exhibited deterioration of performance status (PS3 on the ECOG scale) and required oxygen; therefore, emergency surgery was performed. Operative findings included bloody abdominal ascites and peritoneal dissemination. The large tumor arose from the small bowel mesentery, and infiltrated into the cecum and sigmoid colon. Tumor excision with ileocecal resection and sigmoidectomy was performed. Histopathological examination revealed dedifferentiated liposarcoma. The patient was discharged on postoperative day 22, but pre-discharge CT revealed a recurrent liposarcoma in the retroperitoneum. Therefore, chemotherapy was initiated and the treatment has been continued for over 6 months after surgery. Due to the rarity of this disease, there is no consensus regarding treatment strategies for DDLPS with peritoneal dissemination or in patients with a poor general condition, especially in the setting of oncologic emergency. In this case, multimodal treatment was used to successfully manage this life-threatening state and obtain satisfactory therapeutic results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lee ATJ, Thway K, Huang PH, et al. Clinical and Molecular Spectrum of Liposarcoma. J Clin Oncol. 2018;36:151–9.

    Article  CAS  Google Scholar 

  2. Ducimetière F, Lurkin A, Ranchère-Vince D, et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS ONE. 2011;6:e20294.

    Article  Google Scholar 

  3. Fletcher CD, Unni KK, Mertens F, editors. Pathology and genetics of tumours of soft tissue and bone. Iarc; 2002.

  4. Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology. 2014;46:95–104.

    Article  CAS  Google Scholar 

  5. Fletcher CD. The evolving classification of soft tissue tumours: an update based on the new WHO classification. Histopathology. 2006;48:3–12.

    Article  CAS  Google Scholar 

  6. Cha EJ. Dedifferentiated liposarcoma of the small bowel mesentery presenting as a submucosal mass. World J Gastrointest Oncol. 2011;3:116–8.

    Article  Google Scholar 

  7. Meher S, Mishra TS, Rath S, et al. Giant dedifferentiated liposarcoma of small bowel mesentery: a case report. World J Surg Oncol. 2016;14:250.

    Article  Google Scholar 

  8. Hasegawa T, Seki K, Hasegawa F, et al. Dedifferentiated liposarcoma of retroperitoneum and mesentery: varied growth patterns and histological grades–a clinicopathologic study of 32 cases. Hum Pathol. 2000;31:717–27.

    Article  CAS  Google Scholar 

  9. Korukluoglu B, Ergul E, Sisman IC, et al. Giant primary synchronously bilateral mesenteric dedifferentiated liposarcoma with hyperparathyroidism, hyperthyroidism, type-2 diabetes mellitus and hypertension. J Pak Med Assoc. 2009;59:563–5.

    PubMed  Google Scholar 

  10. Grifasi C, Calogero A, Carlomagno N, et al. Intraperitoneal dedifferentiated liposarcoma showing MDM2 amplification: case report. World J Surg Oncol. 2013;11:305.

    Article  Google Scholar 

  11. Vats M, Pandey D, Ahlawat H, et al. Multiple Primary Dedifferentiated Liposarcoma of the Jejunal Mesentery: A Case Report and Review of Literature. J Clin Diagn Res. 2016;10:Xd01–4.

    PubMed  PubMed Central  Google Scholar 

  12. Matsuo K, Inoue M, Shirai Y, et al. Primary small bowel mesentery de-differentiated liposarcoma causing torsion with no recurrence for 5 years: A case report and review of the literature. Medicine (Baltimore). 2018;97:e13446.

    Article  Google Scholar 

  13. Thway K. Well-differentiated liposarcoma and dedifferentiated liposarcoma: An updated review. Semin Diagn Pathol. 2019;36:112–21.

    Article  Google Scholar 

  14. Thway K, Flora R, Shah C, et al. Diagnostic utility of p16, CDK4, and MDM2 as an immunohistochemical panel in distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors. Am J Surg Pathol. 2012;36:462–9.

    Article  Google Scholar 

  15. Cahlon O, Brennan MF, Jia X, et al. A postoperative nomogram for local recurrence risk in extremity soft tissue sarcomas after limb-sparing surgery without adjuvant radiation. Ann Surg. 2012;255:343–7.

    Article  Google Scholar 

  16. Gronchi A, Strauss DC, Miceli R, et al. Variability in Patterns of Recurrence After Resection of Primary Retroperitoneal Sarcoma (RPS): A Report on 1007 Patients From the Multi-institutional Collaborative RPS Working Group. Ann Surg. 2016;263:1002–9.

    Article  Google Scholar 

  17. Crago AM, Dickson MA. Liposarcoma: Multimodality Management and Future Targeted Therapies. Surg Oncol Clin N Am. 2016;25:761–73.

    Article  Google Scholar 

  18. Schöffski P, Cornillie J, Wozniak A, et al. Soft tissue sarcoma: an update on systemic treatment options for patients with advanced disease. Oncol Res Treat. 2014;37:355–62.

    Article  Google Scholar 

  19. Schöffski P, Chawla S, Maki RG, et al. Eribulin versus dacarbazine in previously treated patients with advanced liposarcoma or leiomyosarcoma: a randomised, open-label, multicentre, phase 3 trial. Lancet. 2016;387:1629–37.

    Article  Google Scholar 

  20. Samuels BL, Chawla SP, Somaiah N, et al. Results of a prospective phase 2 study of pazopanib in patients with advanced intermediate-grade or high-grade liposarcoma. Cancer. 2017;123:4640–7.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Yuichi Motoyama of the Department of Pathology, Graduate School of Medicine, Osaka University, for providing the pathology photos and knowledge about liposarcoma pathology, and San Francisco Edit for English language editing.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2 2-2 Yamadaoka, Suita, Osaka, Japan

    Ryota Mori, Takayuki Ogino, Shiki Fujino, Hidekazu Takahashi, Norikatsu Miyoshi, Mamoru Uemura, Taroh Satoh, Tsunekazu Mizushima, Yuichiro Doki & Hidetoshi Eguchi

Authors
  1. Ryota Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takayuki Ogino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shiki Fujino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hidekazu Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Norikatsu Miyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mamoru Uemura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Taroh Satoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tsunekazu Mizushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yuichiro Doki
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hidetoshi Eguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takayuki Ogino.

Ethics declarations

Conflict of interest

Ryota Mori, Takayuki Ogino, Shiki Fujino, Hidekazu Takahashi, Norikatsu Miyoshi, Mamoru Uemura, Taroh Satoh, Tsunekazu Mizushima, Yuichiro Doki and Hidetoshi Eguchi declare that they have no conflict of interest.

Human rights

All the procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mori, R., Ogino, T., Fujino, S. et al. An oncologic emergency case of massive dedifferentiated liposarcoma of the small bowel mesentery. Clin J Gastroenterol 14, 759–764 (2021). https://doi.org/10.1007/s12328-021-01350-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-021-01350-5

Keywords

Search

Navigation