The Teaching Point

Although dedifferentiated liposarcomas are relatively rare in the extremities, small areas of macroscopic fat and areas of myxoid change in a predominantly solid soft tissue tumor may prospectively characterize a lesion as a liposarcoma; otherwise a nonspecific sarcomatous appearance is exhibited which may not be easily distinguishable on imaging from other types of soft tissue sarcoma. Definitive characterization can be performed with tissue histology; molecular and genetic markers, if available, are highly sensitive and specific.






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Primary Dedifferentiated Liposarcoma of the Axilla Arising in a Mixed, Well-differentiated and Myxoid Liposarcoma

Free full text article: Primary Dedifferentiated Liposarcoma of the Axilla Arising in a Mixed, Well-differentiated and Myxoid Liposarcoma

Abstract
We describe a case of mixed liposarcoma of the axilla presenting as a high grade undifferentiated sarcoma with areas of well-differentiated and myxoid liposarcoma. MRI demonstrated a lobulated, septated intermuscular mass with marked heterogeneous gadolinium enhancement. A small focus of the tumor demonstrated fat suppressed signal more characteristic of well-differentiated liposarcoma. Pathologic analysis following wide local excision revealed a large, high grade sarcomatous component with highly pleomorphic cells with a thin rim of well-differentiated and myxoid liposarcoma on histologic examination. Dedifferentiated liposarcomas arising outside of the retroperitoneum are very rare, as are dedifferentiated liposarcomas arising from a histologically mixed liposarcoma. In this regard, this case illustrates an unusual combination of tumor location and histology which, to our knowledge, has not previously been reported.






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1. Liposarcoma

2. myxoid

3. upper extremity

4. axilla

5. magnetic resonance imaging


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