Open Access

Giant liposarcoma of the back with 4 types of histopathology: a case report

  • Panoraia Paraskeva1Email author,
  • Paraskevas Katsaronis1,
  • Eleftherios D Spartalis1,
  • Andreas C Lazaris2,
  • Hara Gakiopoulou2,
  • Panagiotis Mallis3 and
  • Periklis Tomos1
Cases Journal20092:9339

https://doi.org/10.1186/1757-1626-2-9339

Received: 20 October 2009

Accepted: 16 December 2009

Published: 16 December 2009

Abstract

The incidence of soft tissue tumours, both malignant and benign, is very common. However, the coexistence of 4 types of histopathology is rare and the aim of this article is to present one treated in our Department. An 87-year-old Greek man was treated in our Department for a huge tumour on his back, under local anaesthesia. The pathology report of the specimen referred 4 types of neoplasia. This case represents this incidence in a giant liposarcoma of the back.

Introduction

Soft tissue tumours are very common in the general population. Most of them are benign and they require excision for functional and appearance reasons. In literature the incidence of 4 types of histopathology in a specimen is very rare[1] and our aim is to present one.

Case presentation

An 87-year-old Greek man, who had been generally active and his past medical history was free of disease, was referred to our hospital for a giant swelling on his back. He has had this tumor since at least 10 years, but he had not undergone an operation as it has been asymptomatic (Fig. 1). Due to the dimensions of the tumor, the patient has undertaken a chest computer tomography scan in order to determine the borders and the invasion of the tumor to the surrounding tissues (Fig. 2)
Figure 1

Preoperative image of the patient

Figure 2

Chest CT scan of the patient

The patient was referred for a surgical removal of the tumor. Due to his age, he has not taken general anesthesia and the whole operation has been under regional anesthesia. Intraoperatively, a giant liposarcoma, 18 × 14 × 6 cm, was found and been removed and also another tumor, 12 × 10 × 8 cm, white and homogenous (Fig. 3, 4, 5).
Figure 3

The tumor during the operation

Figure 4

The actual size of the tumor

Figure 5

The area of the removed lesion

The pathology report referred 4 types of neoplasia. There was growth of mesenchymal neoplasma with figure of non-differentiated liposarcoma. There was also growth of well-differentiated liposarcoma (Fig. 6), whereas in the non-differentiated parts of the tumor malignant fibrous histiocytoma (Fig. 7), osteosarcoma (Fig. 8), chondrosarcoma (Fig. 9) and parts with pericellular pattern were found. The skin segment was soft fibroma.
Figure 6

Growth of well differentiated liposarcoma (x 100) hematoxylin and eosin staining

Figure 7

Non-differentiated part of the tumor with the pattern of malignant fibrous histiocytoma (x 100) hematoxylin and eosin staining

Figure 8

Part of osteosarcoma (X 200) hematoxylin and eosin staining

Figure 9

Part od chondrosarcoma (x 100) hematoxylin and eosin staining

The perioperative period was uneventful and the patient was discharged home 3 days later.

Discussion

The existence of 4 histological types of neoplasia is very rare and was treated surgically under local anesthesia. Preoperative evaluation of such tumours is essential in order to determine the borders and characterize the tumour [2]. This can be done either with CT scan or MRI scan. The definite diagnosis is set by histology and requires careful analysis of the specimen.

Consent

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Declarations

Authors’ Affiliations

(1)
2nd Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Medical School
(2)
1st Department of Pathology, National and Kapodistrian University of Athens, Medical School
(3)
ENT Department, "Laiko" General Hospital of Athens

References

  1. Shoji T, Sonobe M, Okubo K, Wada H, Bando T, Date H: Giant primary liposarcoma of the chest. Gen Thorac Cardiovasc Surg. 2009, 57 (3): 159-61. 10.1007/s11748-008-0329-5. Epub 2009 Mar 12View ArticlePubMedGoogle Scholar
  2. Lahat G, Madewell JE, Anaya DA, Qiao W, Tuvin D, Benjamin RS, Lev DC, Pollock RE: Computed tomography scan-driven selection of treatment for retroperitoneal liposarcoma histologic subtypes. Cancer. 2009, 115 (5): 1081-90. 10.1002/cncr.24045.View ArticlePubMedGoogle Scholar

Copyright

© Paraskeva et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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