Objective: To investigate the clinicopathologic and molecular genetic characteristics of myxoid pleomorphic liposarcoma (MPLPS). Methods: Six cases of MPLPS diagnosed and consulted in Fujian Provincial Hospital from 2015 to 2021 were collected for histomorphological observation, immunohistochemistry, and fluorescence in situ hybridization (FISH) detection of DDIT3 (CHOP) gene translocation and MDM2/CDK4 gene amplification. Results: There were four males and two females, aged 26-74 years (mean 53.8 years). The tumor size was 3.8-16.0 cm (mean 11.8 cm). All six cases had similar histopathologic features, showing overlapping histologic morphology of myxoid liposarcoma and pleomorphic liposarcoma. Four cases (4/6) were positive for S-100 protein, and the Ki-67 index was 50%-95%. All cases (6/6) were negative for DDIT3 (CHOP) translocation and MDM2/CDK4 amplification by FISH. TP53 (p.R248w) germline mutation was found in one case. Conclusions: MPLPS is a rare subtype of liposarcoma, characterized by overlapping morphology of myxoid liposarcoma and pleomorphic liposarcoma. Genetically, a few of them have TP53 gene germline mutations, but they lack of DDIT3 (CHOP) translocation or MDM2/CDK4 amplification.
Female ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Liposarcoma/pathology* ; Liposarcoma, Myxoid/diagnosis* ; Male ; Molecular Biology ; Proto-Oncogene Proteins c-mdm2/genetics* ; Translocation, Genetic

PURPOSE: The purpose of this study was to characterize and evaluate the clinical significance of volume changes of soft tissue sarcomas during radiation therapy (RT), prior to definitive surgical resection. MATERIALS AND METHODS: Patients with extremity or pelvis soft tissue sarcomas treated at our institution from 2013 to 2016 with RT prior to resection were identified retrospectively. Tumor volumes were measured using cone-beam computed tomography obtained daily during RT. Linear regression evaluated the linearity of volume changes. Kruskal-Wallis tests, Mann-Whitney U tests, and linear regression evaluated predictors of volume change. Logistic and Cox regression evaluated volume change as a predictor of resection margin status, histologic treatment response, and tumor recurrence. RESULTS: Thirty-three patients were evaluated. Twenty-nine tumors were high grade. Prior to RT, median tumor volume was 189 mL (range, 7.2 to 4,885 mL). Sixteen tumors demonstrated significant linear volume changes during RT. Of these, 5 tumors increased and 11 decreased in volume. Myxoid liposarcoma (n = 5, 15%) predicted decreasing tumor volume (p = 0.0002). Sequential chemoradiation (n = 4, 12%) predicted increasing tumor volume (p = 0.008) and corresponded to longer times from diagnosis to RT (p = 0.01). Resection margins were positive in three cases. Five patients experienced local recurrence, and 7 experienced distant recurrence, at median 8.9 and 6.9 months post-resection, respectively. Volume changes did not predict resection margin status, local recurrence, or distant recurrence. CONCLUSION: Volume changes of pelvis and extremity soft tissue sarcomas followed linear trends during RT. Volume changes reflected histologic subtype and treatment characteristics but did not predict margin status or recurrence after resection.
Cone-Beam Computed Tomography ; Diagnosis ; Extremities ; Humans ; Linear Models ; Liposarcoma, Myxoid ; Pelvis ; Recurrence ; Retrospective Studies ; Sarcoma ; Tumor Burden

Myxoid liposarcoma arose from the spermatic cord is very rare. Also, it is difficult to diagnose by clinical findings or radiologic study. Even if it was a malignant tumor, scrotal malignancy is often misdiagnosed in many cases. A 55-year-old man presented with a mass in the left scrotum. Tumor markers showed all normal range. A scrotal magnetic resonance imaging scan revealed a vascular tumor such as a hemangioma. But, we performed radical orchiectomy. The mass was diagnosed as paratesticular myxoid liposarcoma. It is important to keep in mind the differential diagnosis of paratesticular liposarcoma in the case of a painless scrotal tumor.
Biomarkers, Tumor ; Diagnosis, Differential ; Hemangioma ; Humans ; Liposarcoma ; Liposarcoma, Myxoid ; Magnetic Resonance Imaging ; Middle Aged ; Orchiectomy ; Reference Values ; Scrotum ; Spermatic Cord

Primary mesenteric liposarcoma is rare. It is difficult to make an accurate preoperative diagnosis of the myxoid type of liposarcoma by using imaging such as ultrasound or computed tomography (CT) due to the very small amount of fat that is located in the tumor. We report a case of primary myxoid liposarcoma of the mesentery which was difficult to differentiate from other solid mesenteric tumors with a myxoid component such as low grade fibromyxoid sarcoma, myxoid leiomyosarcoma or myxoma. Use of chemical shift magnetic resonance (MR) imaging to detect small fat components and its cystic appearance with solid components on the MR images can be useful to differentiate myxoid liposarcoma from the other mesenteric tumors with a myxoid component.
Diagnosis ; Leiomyosarcoma ; Liposarcoma ; Liposarcoma, Myxoid* ; Magnetic Resonance Imaging ; Mesentery* ; Myxoma ; Sarcoma ; Ultrasonography

OBJECTIVETo study the diagnostic value and pitfalls of ultrasound-guided core needle biopsy (CNB) of soft tissue tumors.

METHODSOne hundred and six cases of CNB specimens encountered during the period from 2007 to 2012 were enrolled into the study. The pathologic diagnosis using CNB was compared with that using surgical specimens. Diagnostic accuracy was analyzed using Chi-square test, with respect to the histologic pattern (such as spindle cell and myxoid), biologic behavior (benign versus malignant) and immunohistochemical results. The 59 cases of sarcoma were subdivided into three grades according to FNCLCC grading system.

RESULTSHistologic diagnosis could be made in 84.0% (89/106) cases. Thirteen cases were non-diagnostic on CNB. There were 4 cases on CNB showing diagnostic discrepancy with surgical specimens. Four cases of "benign lesions" on CNB found to be myxoid liposarcoma and lipoma-like liposarcoma upon resection. In general, myxoid pattern (9/17) seen on CNB showed less diagnostic correlation with surgical specimens, as compared to spindle cell and other histologic patterns (P < 0.01). The rate of diagnostic correlation was 79.7% (49/59) for the 59 cases of sarcoma studied, with grade 2 and grade 3 sarcoma showing better correlation (in contrast to 7/17 for grade 1 sarcoma) (P < 0.01). Comparative analysis showed no significant difference between benign/borderline tumors and sarcomas. The application of immunohistochemical study did not result in significant improvement in diagnostic accuracy on CNB.

CONCLUSIONSUltrasound-guided CNB is a reliable tool in pathologic diagnosis of soft tissue tumors and shows a high accuracy rate especially for high-grade sarcoma. Tumors with myxoid pattern, lipomatous tumors and grade 1 sarcomas are associated with lower diagnostic accuracy on CNB. Correlation with clinicoradiologic findings would also be helpful in diagnostic evaluation and surgical planning.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Large-Core Needle ; methods ; Diagnostic Errors ; Extremities ; Female ; Humans ; Liposarcoma, Myxoid ; diagnosis ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neoplasm Grading ; Sarcoma ; diagnosis ; diagnostic imaging ; pathology ; Soft Tissue Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Ultrasonography, Interventional ; methods ; Young Adult

12E7 Antigen ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Diagnosis, Differential ; Head and Neck Neoplasms ; metabolism ; pathology ; Hemangioma ; pathology ; Humans ; Lipoma ; metabolism ; pathology ; Liposarcoma, Myxoid ; pathology ; Male ; Middle Aged ; S100 Proteins ; metabolism ; Soft Tissue Neoplasms ; metabolism ; pathology

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

Adult ; Humans ; Liposarcoma, Myxoid ; diagnosis ; Male ; Mediastinum ; pathology

Angiomyxolipoma is a rare variant of lipoma and seven cases have been reported in the English literature. The reported cases mostly presented with a well-demarcated, asymptomatic, solitary, subcutaneous mass on the scalp or extremities. Histopathologic features of this tumor are characteristic and consist of the paucicellular myxoid areas and the mature fat tissue, with numerous thin, dilated blood vessels. The important histopathological differential diagnoses include myxoid spindle cell lipoma, myxoid lipoma, angiolipoma, angiomyolipoma, superficial angiomyxoma, myxoid liposarcoma and low-grade myxofibrosarcoma. We describe a 38-year-old man with multiple angiomyxolipoma on the gluteal area and the upper and lower extremities.
Adult ; Angiolipoma ; Angiomyolipoma ; Blood Vessels ; Diagnosis, Differential ; Extremities ; Humans ; Lipoma ; Liposarcoma, Myxoid ; Lower Extremity ; Myxoma ; Scalp

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