Liposarcoma is one of the most common soft tissue sarcomas that occurs in adults and is currently divided into five main subgroups: well-differentiated, myxoid, round cell, pleomorphic, and dedifferentiated. Primary mesenteric liposarcoma is extremely rare, and the treatment strategy is surgical resection with a wide free margin, often followed by radiation and adjuvant chemotherapy if distant metastasis is not detected. A 73-year-old male patient presented with lower abdominal distension. Abdominal CT scan revealed a large homogeneously enhancing mass lesion abutting the sigmoid colon and urinary bladder. At laparotomy, the solid mass measured 28x26x12 cm in size, was well-demarcated, and originated from the mesentery of the middle ileum. It was removed along with some small intestine (ileocecal valve upper 50-150 cm) and ileal mesentery because of adhesion. Histologically, the tumor proved to be pleomorphic liposarcoma. The patient did not undergo any adjuvant treatment following surgery, but he remains disease free until 33 months after surgery. Herein, we report a case of pleomorphic liposarcoma arising from small bowel mesentery.
Aged ; Humans ; Liposarcoma/*diagnosis/pathology/surgery ; Male ; Mesentery/*pathology ; Peritoneal Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

Adult ; Diagnosis, Differential ; Heart Neoplasms ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Liposarcoma, Myxoid ; metabolism ; pathology ; surgery ; Male ; Myxoma ; metabolism ; pathology ; Myxosarcoma ; metabolism ; pathology ; Pericardium ; S100 Proteins ; metabolism ; Vimentin ; metabolism

Aged ; Diagnosis, Differential ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Lipoma ; pathology ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; S100 Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Abdominal Neoplasms ; metabolism ; pathology ; surgery ; Actins ; metabolism ; Angiomyolipoma ; metabolism ; pathology ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Leiomyosarcoma ; metabolism ; pathology ; surgery ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Retroperitoneal Neoplasms ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism

A liposarcoma is the most common soft tissue sarcoma in adults with an incidence of about 20% of all soft tissue sarcomas. Although incidence differs from a region of origination, a case arisen from mesentery has rarely been reported. We experienced a case of liposarcoma arising from the mesentery of a 51-year-old male patient. He was treated by wide excision. Histologically, the tumor was composed of a mixed well-differentiated liposarcoma with myxoid and spindle cell type.
Diagnosis, Differential ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Liposarcoma/*diagnosis/pathology/surgery ; Magnetic Resonance Imaging ; Male ; Mesentery/*pathology ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo summarize the diagnostic features of fine needle aspiration cytology (FNAC) of myxoid lesions in soft tissue, and to define the cytological criteria for differentiating benign lesions from sarcomas and between various myxoid lesions.

METHODSFNAC data of 24 soft tissue myxoid lesions (14 benign lesions, 10 malignant lesions) from 1993 to 2006 from Kiang Wu Hospital, Macau were reviewed in correlation with the clinical course or the results of biopsy.

RESULTSGanglion, myxoma, and myxoid nodular fasciitis were the most common benign myxoid lesions of the soft tissues, all of which had low cellularity and lack of marked cellular atypia in smears in common. Ganglion was characterized by the disappearance of or the gradual minimization of the nodule after aspiration and the lack of blood vessel in smears. Myxoid nodular fasciitis was characterized by a pleomorphic pattern of proliferative cells and the presence of ganglion cell-like cells. Myxoid liposarcoma, extraskeletal myxoid chondrosarcoma and myxofibrosarcoma were the most common myxoid sarcomas. Cytologically, they had high cellularity and various degrees of cellular atypia. Myxoid liposarcoma exhibited branching chicken-wire like capillary vessels and/or lipoblasts; myxofibrosarcoma were prominent in both pleomorphic and atypia of the cells. The data revealed that the diagnostic accuracy of FNAC was nearly 100% in differentiating benign and malignant myxoid lesions of the soft tissues. The coordinate rate to the histopathology diagnosis of the common myxoid lesions of the soft tissues was above 75% (benign 71.4% and malignancy 80% respectively).

CONCLUSIONSFNAC is an effective method in diagnosing myxoid lesions of soft tissue, in correlation with the clinical data and the accessory examinations. FNAC can provide an objective basis for the treatment of myxoid lesions and prevention of unnecessary surgical operations.

Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; methods ; Bone Neoplasms ; pathology ; surgery ; Chondrosarcoma ; pathology ; surgery ; Diagnosis, Differential ; Fasciitis ; pathology ; surgery ; Female ; Fibrosarcoma ; pathology ; surgery ; Ganglion Cysts ; pathology ; surgery ; Humans ; Liposarcoma, Myxoid ; pathology ; surgery ; Male ; Middle Aged ; Myxoma ; pathology ; surgery ; Prognosis ; Sarcoma ; pathology ; surgery ; Soft Tissue Neoplasms ; pathology ; surgery ; Young Adult

Diagnosis, Differential ; Femur ; Fibrosarcoma ; metabolism ; pathology ; Fibrous Dysplasia of Bone ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Leg ; Liposarcoma, Myxoid ; metabolism ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle Neoplasms ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Myxoma ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Neurilemmoma ; metabolism ; pathology ; Neurofibroma ; metabolism ; pathology ; Syndrome ; Tomography, X-Ray Computed ; Vimentin ; metabolism ; beta Catenin ; metabolism