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Chirurgie 1. Juli 2015

Liposarcoma with lymph node spread: a case presentation and a systematic review of the literature

Background: Liposarcomas are neoplasms of mesodermic origin derived from adipose tissue. Metastases at the time of initial presentation are uncommon, and the spread to regional nodes is extremely infrequent. The aim of this work is to present a rare case of a giant liposarcoma, presenting with regional lymph node extension, and composed of three different histological subtypes and present a systematic review of all the cases described in the literature of liposarcoma with lymphatic extension.

Methods: A 71-year-old woman presented with a giant retroperitoneal liposarcoma with lymph node invasion. Excision of the tumor en bloc with right radical nephrectomy and lymphadenectomy was performed. Histological analysis revealed a mixed-type liposarcoma consisting of well-differentiated, myxoid, and pleomorphic components, and lymph node involvement. A systematic review of the literature of the cases of liposarcoma with lymph node involvement was performed.

Results: This is the first description of a retroperitoneal liposarcoma with lymphatic involvement. There are only seven articles, including 9 patients, in literature describing lymph node invasion of liposarcomas. The majority are dedifferentiated liposarcomas.

Conclusions: Giant retroperitoneal liposarcomas with mixed histological pattern and lymph node invasion are rare presentation in the literature and associated with a poor prognosis. The available data are spare, and our understanding of these tumors is limited, with no known effective therapy.

I.B. Correia de Sá, J. Carvalho, R. Silva, P. Ferreira, L. Matos-Lima, A. Taveira-Gomes, European Surgery 3/2015

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