A Giant Well-differentiated Liposarcoma: A Case Report
Keywords:
Liposarcomas, LS, Well-differentiated liposarcoma, WDLPS, atypical lipomatous tumor, ALT, Saudi ArabiaAbstract
We report a rare case of an enormous well-differentiated liposarcoma (WDLPS) in a patient aged <40 years. A 39 years old Saudi male patient presented with a swelling in the upper, medial aspect of the right thigh. It was a large swelling, about 15 x 15 cm. All blood investigations were unremarkable. CT scan revealed a huge (20.1 x 20 cm) well-defined lobulated heterogeneous, hypodense subcutaneous lesion on the medial aspect of the right upper thigh, extending superiorly to the subcutaneous area of the ipsilateral natal cleft and inferiorly down to the mid-thigh level. The lesion showed multiple internal septations with a solitary spot of tiny fatty component. The entire mass was excised en bloc with its capsule. It was huge, but encapsulated. Histopathology reported a multinodular mass with infiltrative margins, measuring approximately 24 x 20 x 13 cm in greatest dimensions. The cut surface was lobulated, gelatinous, and myxoid, with grey-white, firm nodules and focal areas of haemorrhage and necrosis. Microscopic sections of the mass revealed a malignant lipomatous tumour comprising mature adipocytes, atypical spindle cells, and multivacuolated lipoblasts, embedded in a loose myxoid stroma with focal dense fibrous stroma. Few scattered mitotic figures were seen. No infiltration of the overlying skin (about 2 cm margin) was seen, and no invasion of all other margins (< 1 cm) found. No recurrence was seen in follow-up. Documentation of LS incidence among Saudis is scarce, but it is rising in the USA and Europe. With genetic predisposition in the White population.
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