Myxoid liposarcoma is the major subtype of liposarcoma and commonly presents in the extremities, particularly in the thigh. We introduce an unusual case of a myxoid liposarcoma presenting as a large perineal swelling occupying the para-rectal and para-anal spaces in a 49-yearold male patient. The diagnosis, management, and prognosis of myxoid liposarcoma are discussed. A literature review is performed for myxoid liposarcoma.

Healthcare providers are responsible for performing medical check-ups, analyse and interpret patient's laboratory results. It is common for an initially asymptomatic patient to receive abnormal results including liver enzymes such as alkaline phosphatase (ALP). The concern in these patients is the cut-off value for mildly elevated levels that requires intervention. This paper reports a case of liver malignancy in a 32-year-old man who presented with a mild elevation of ALP level less than five times the upper limit of normal. The patient had no clinical symptoms. Early ultrasound liver assessment showed dilated common bile duct, which led to an urgent CT scan of the liver that revealed supportive features of fibrolamellar carcinoma. The patient was managed successfully with early partial hepatectomy that has saved him from morbidity and mortality of liver malignancy. Indeed, liver malignancy can be detected early in a health clinic from a further assessment of trivial elevation of ALP.