Retroperitoneal well-differentiated inflammatory liposarcoma: a diagnostic dilemma

Radiation Medicine - Tập 26 - Trang 450-453 - 2008
Rinsaku Kawano1, Akihiro Nishie1, Kengo Yoshimitsu1, Hiroyuki Irie1, Tsuyoshi Tajima1, Masakazu Hirakawa1, Kousei Ishigami1, Yasuhiro Ushijima1, Daisuke Okamoto1, Hidetake Yabuuchi1, Akinobu Taketomi2, Yunosuke Nishihara3, Nobuhiro Fujita3, Hiroshi Honda1
1Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
3Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Tóm tắt

We present a case of retroperitoneal well-differentiated inflammatory liposarcoma that was extremely difficult to diagnose preoperatively. Computed tomography and magnetic resonance images showed a 5-cm homogeneous soft-tissue mass with a decreased apparent diffusion coefficient and without fat component in the retroperitoneum. Minimal fat stranding was detected around the mass. The preoperative working diagnosis was malignant lymphoma or inflammatory pseudotumor, whereas the final diagnosis after surgery was well-differentiated inflammatory liposarcoma. As a result, only a large component of lymphoid infiltration was recognized as a tumor preoperatively, and minimal fat stranding represented a component of lipoma-like liposarcoma. In this entity, a lipomatous component could easily be missed on radiologic imaging because of the conspicuity of lymphoid infiltration. We should consider the possibility of this variant when we evaluate a retroperitoneal tumor.

Tài liệu tham khảo

Nishino M, Hayakawa K, Minami M, Yamamoto A, Ueda H, Takasu K. Primary retroperitoneal neoplasms: CT and MRI imaging findings with anatomic and pathologic diagnostic clues. Radiographics 2003;23:45–57. Noguchi H, Naomoto Y, Haisa M, et al. Retroperitoneal liposarcoma presenting a indirect inguinal hernia. Acta Med Okayama 2001;55:51–54. Murphy MD, Arcara LK, Fanburg-Smith J. From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics 2005;25:1371–1395. Argani P, Facchetti F, Inghirami G, Rosai J. Lymphocyte-rich well-differentiated liposarcoma: report of nine cases. Am J Surg Pathol 1997;21:884–895. Kraus M, Guillou L, Fletcher CDM. Well-differentiated inflammatory liposarcoma: an uncommon and easily over-looked variant of a common sarcoma. Am J Surg Pathol 1997;21:518–527. Mehrotra PK, Ramachandran CS, Goel D, Arora V. Inflammatory variant of a well-differentiated retroperitoneal liposarcoma: case report of a rare giant variety. Indian J Cancer 2006;43:36–38. Adachi T, Oda Y, Sakamoto A, et al. Immunoreactivity of p53, mdm2, and p21WAF1 in dedifferentiated liposarcoma: special emphasis on the distinct immunophenotype of the well-differentiated component. Int J Surg Pathol 2001;9:99–109. Nakayama T, Yoshimitsu K, Irie H, et al. Usefulness of the calculated apparent diffusion coefficient value in the differential diagnosis of retroperitoneal masses. J Magn Reson Imaging 2004;20:735–742. Hoshi M, Matsumoto S, Manabe J, et al. Surgery for dedifferentiated liposarcoma, presenting two radiologically and pathologically distinctive patterns. Jpn J Clin Oncol 2006;36:462–467.