PURPOSE: Although liposarcoma is the second most common soft tissue sarcoma in adults, the incidence of liposarcoma of the head and neck is rare. There is only one reported case in Korea and moreover, only in adolescence. We report a case of liposarcoma on the neck in a 32-year-old male in adult. METHODS: The patient had a slow growing, none tender mass on the posterior neck without lymphadenopathy, which has been present for 3 years and recurred twice during that time. MRI showed a 1.5cm sized ovoid, well demarcated mass that was located in the subcutaneous layer of the posterior neck. RESULTS: The mass was surgically removed. The resection margin was free of tumor on frozen biopsy and histopathologic examination indicated myxoid and round cell liposarcoma. The whole body F-18 FDG PET-CT applied on the fourteenth day postoperatively, revealed a moderate FDG-uptaking soft tissue lesion showing postoperative wound healing process on the posterior neck region and there was no distant metastasis. CONCLUSION: Liposarcoma is the second most common soft tissue sarcoma in adults. But, it rarely involves the head and neck region. Prognosis is principally dependent on histologic subtype and grade. Low grade liposarcoma such as well differentiated and myxoid liposarcoma tend to recur locally, rarely metastasize. On the other hand, high grade liposarcoma such as round cell and pleomorphic liposarcoma have higher rates of local recurrence and distant metastasis. Complete surgical excision provides the most effective means of treatment. Radiotherapy or chemotherapy can be used as an asjunctive treatment modality.
Adolescent ; Adult* ; Biopsy ; Drug Therapy ; Hand ; Head ; Humans ; Incidence ; Korea ; Liposarcoma* ; Liposarcoma, Myxoid ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Male ; Neck* ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence ; Sarcoma ; Wound Healing

PURPOSE: Although liposarcoma is the second most common soft tissue sarcoma in adults, the incidence of liposarcoma of the head and neck is rare. There is only one reported case in Korea and moreover, only in adolescence. We report a case of liposarcoma on the neck in a 32-year-old male in adult. METHODS: The patient had a slow growing, none tender mass on the posterior neck without lymphadenopathy, which has been present for 3 years and recurred twice during that time. MRI showed a 1.5cm sized ovoid, well demarcated mass that was located in the subcutaneous layer of the posterior neck. RESULTS: The mass was surgically removed. The resection margin was free of tumor on frozen biopsy and histopathologic examination indicated myxoid and round cell liposarcoma. The whole body F-18 FDG PET-CT applied on the fourteenth day postoperatively, revealed a moderate FDG-uptaking soft tissue lesion showing postoperative wound healing process on the posterior neck region and there was no distant metastasis. CONCLUSION: Liposarcoma is the second most common soft tissue sarcoma in adults. But, it rarely involves the head and neck region. Prognosis is principally dependent on histologic subtype and grade. Low grade liposarcoma such as well differentiated and myxoid liposarcoma tend to recur locally, rarely metastasize. On the other hand, high grade liposarcoma such as round cell and pleomorphic liposarcoma have higher rates of local recurrence and distant metastasis. Complete surgical excision provides the most effective means of treatment. Radiotherapy or chemotherapy can be used as an asjunctive treatment modality.
Adolescent ; Adult* ; Biopsy ; Drug Therapy ; Hand ; Head ; Humans ; Incidence ; Korea ; Liposarcoma* ; Liposarcoma, Myxoid ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Male ; Neck* ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence ; Sarcoma ; Wound Healing

We report on a first case of bone marrow metastasis by dedifferentiated liposarcoma. A 39-year-old male diagnosed with retroperitoneal dedifferentiated liposarcoma underwent surgery and postoperative radiotherapy. In spite of radiotherapy, his whole-body positron emission tomography showed high uptake in multiple bone metastasis. With thrombocytopenia, bone scan suggested bone marrow involvement. After bone marrow biopsy, bone marrow metastasis by dedifferentiated liposarcoma was finally confirmed. He was administered with systemic chemotherapy with doxorubicin. But he died 3 months after chemotherapy due to disease progression. This case revealed that in a patient of unexplained cytopenia with dedifferentiated liposarcoma, bone marrow metastasis should be in consideration.
Adult ; Biopsy ; Bone Marrow* ; Disease Progression ; Doxorubicin ; Drug Therapy ; Humans ; Liposarcoma* ; Male ; Neoplasm Metastasis ; Positron-Emission Tomography ; Radiotherapy ; Thrombocytopenia

Seventy four patients with soft tissue sarcomas treated by postoperative radiotherapy in the Department of Therapeutic Radiology, Seoul National University Hospital between August 1979 and September 1990 were analyzed. The follow-up period ranged from 3 to 145 months with a median of 51 months. Liposarcoma and malignant fibrous histiocytoma(MFH) constituted 54% of the cases and the histologic grades of tumors are as follows: grad I, 23 case; grade II, 17 cases; grad III, 24 cases; unknown grade , 10 cases. The patients were treated by marginal(17 cases), wide(55 cases) or compartmental(2 cases) excision followed by postoperative radiotherapy. The total radiation doses were 4200-8820 cGy(median 6000cGy), 180-200n cGy daily, 5 times per week. Of 74 patients, 35 utimately failed. The local control was 62.2% at 5 years and cumulative rik of distant metastasis was 22.3% at 5 years. The overall survival and disease free survival were 72.3% and 53.3% at 5 years, respectively. Survival after appearance of metastasis was 15.1% at 3 yeaers. Patients with liposarcoma experienced better local control that those with other histologic type and tumor grade and surgical resection margin significantly correlated with local recurrence, distant metastasis and overall survival on univeriate analysis. In conclusion, re-excision is needed for patients with positive surgical resection margin to improve local control and further therapeutic measures using effective chemotherapy should be explored in the hope of improving overall survival.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Hope ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Sarcoma* ; Seoul

Primary tumors of the spermatic cord are rare and basically of connective tissue origin. They are hardly ever considered in the differential diagnosis of intrascrotal swellings. Treatment consisted of radical orchiectomy without retroperitoneal lymph node dissection, and adjuvant radiation and chemotherapy. We report a case of liposarcoma of the spermatic cord in 54-year-old male. He has survived l5 months without evidence of recurrence.
Connective Tissue ; Diagnosis, Differential ; Drug Therapy ; Humans ; Liposarcoma* ; Lymph Node Excision ; Male ; Middle Aged ; Orchiectomy ; Recurrence ; Spermatic Cord*

The soft tissue sarcoma ih the Orthopedic surgery is not common, occuring in less than one percent of all malignant tumors. Whille the sarcoma is comparatively highly malignant, its treatment has been varied, and the effect of the each treatment has been controversial and generally poor on statisties. We studied 58 cases of soft tissue sarcoma in the Orthopedic department of Pusan Gospei Hospital in the 6 years period from March, 1975 to March, 1981. We confirmed the sarcoma diagnosis by biopsy, and measured the size, the degree of local infilteration and occurrence of metastasis with the help of plain X-ray, angiography, lung and bone scan, and computerized tomograms. We made treatment plans according to above results. We classified the soft tissue sarcoma into 8 histologic types and obtained following conclusions: l. Among the 58 cases of soft tissue sarcoma, and majority is consisted of fibrosarcoma, liposarcoma and rhabdomyosarcoma. 2. There were 41 cases occurred in the lower extremity and 17 cases in the upper extremity. Thus soft tissue sarcoma are more frequent in the lower extremity, especially in thigh (2 patients). 3. We found 19 cases between the age of 41 to 50 years. In general, the soft tissue sarcoma are more frequent between the age of 31 to 50 years. 4. Among the 58 cases, 10 patient came to our hospital because of recurrence of soft tissue sarcoma, after receiving local excision in other hospitals. In other words 17 percent of our cases showed recurred sarcoma and duration of recurrence was within 16 months. 5. Metastasis of the soft tissue sarcoma had taken place in 17 patients (29%), most frequently metastasis to the lung in 12 cases (70%). 6. We treated 30 cases by chemotherapy and radiotherapy after excision or amputation. In 15 sarcomas that could not be excised, but the medical treatment with chemotherapy and radiotherapy. 7. The follow-up study revealed better result obtained in the group of aggresive treatment with anticancer chemotherapy and radiotherapy after excision or amputation.
Amputation ; Angiography ; Biopsy ; Busan ; Clinical Study ; Diagnosis ; Drug Therapy ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Liposarcoma ; Lower Extremity ; Lung ; Neoplasm Metastasis ; Orthopedics ; Radiotherapy ; Recurrence ; Rhabdomyosarcoma ; Sarcoma ; Thigh ; Upper Extremity

Azathioprine is frequently used for the treatment of inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis. Lymphomas, squamous cell carcinomas, and undifferentiated pleomorphic sarcomas have been reported among patients receiving azathioprine therapy. Herein, we report a case of pleomorphic liposarcoma of chest wall which occurred in a 44-year-old man with Crohn's disease taking azathioprine. He was diagnosed with Crohn's disease 3 years ago after suffering from abdominal pain and hematochezia for 12 years. He had been taking 50 mg of azathioprine per day for 23 months when he visited the thoracic and cardiovascular surgery clinic due to right chest palpable mass that had rapidly grown during the past 2 months. Excisional biopsy was performed and the mass was diagnosed as pleomorphic liposarcoma. Therefore, he underwent radical excision of the right chest wall mass, which measured 11.0x6.5 cm in size. He is scheduled to receive radiation therapy and chemotherapy.
Adult ; Azathioprine/*therapeutic use ; Colonoscopy ; Combined Modality Therapy ; Crohn Disease/complications/*drug therapy ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Immunosuppressive Agents/*therapeutic use ; Liposarcoma/complications/*pathology/surgery ; Male ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed

Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for liposarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondrosarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.
Biopsy ; Chondrosarcoma ; Diagnosis ; Diaphragm ; Drug Therapy ; Dyspnea ; Heart Rate ; Hematoma ; Hemothorax ; Hospitals, General ; Humans ; Liposarcoma* ; Lung* ; Magnetic Resonance Imaging ; Male ; Mediastinal Neoplasms ; Mediastinum ; Neoplasm Metastasis ; Pericardium ; Pleura* ; Pneumonectomy* ; Pulmonary Artery ; Recurrence ; Sarcoma ; Thoracostomy ; Thoracotomy ; Thorax ; Young Adult

PURPOSE: The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. MATERIAL AND METHODS: Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6- 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12 %). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. RESULTS: Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head andneck primary. This feature is likely explanation for the decreased local control rate. Five of 29 patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). CONCLUSION: Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.
Disease-Free Survival ; Drug Therapy ; Extremities ; Female ; Follow-Up Studies ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Liposarcoma ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Neurilemmoma ; Postoperative Period ; Recurrence ; Retrospective Studies ; Sarcoma* ; Survival Rate

Vascular catheters are associated with complications such as infection, thrombosis and stenosis. The embolization of a venous catheter fragment is a rare complication. A 39-year-old woman underwent placement of a totally implantable venous access device for chemotherapy to treat a recurrent liposarcoma of the left thigh. The "pinch-off sign" was noted on a routine chest X-ray but that was ignored. Three-months after implantation of the intravenous access device, the indwelling central catheter was fractured and embolized to the pulmonary trunk. The catheter in the pulmonary trunk was successfully removed through a percutaneous femoral vein approach using a pigtail catheter and goose neck snare.
Thigh/pathology ; Pulmonary Artery/*injuries/surgery ; Liposarcoma/drug therapy ; Humans ; Foreign-Body Migration/*complications/surgery ; Female ; *Equipment Failure ; Embolism/*etiology/surgery ; Catheters, Indwelling/*adverse effects ; Catheterization, Central Venous/*adverse effects/instrumentation ; Adult