A Study of a Lipomyxosarcoma with Comments Upon the Origin of the Fat Cell

Abstract

Neoplasms of mesenchymal origin are frequently the cause of much controversy owing to a lack of differentiation into tissue which would permit their being placed in a definite organoid category. The term “liposarcoma” has been used to denote malignant change in the connective tissue of a lipoma, itself one of the most benign of tumors, and also to accent the fact that the growing fat cells have invaded the surrounding tissues or metastasized. A tumor which presents the accepted criteria of malignancy, derived from fat cells which are atypical in size, shape, and staining characteristics, with many mitotic figures and invasion of septa and capsule, is of the greatest rarity, and a study of such a growth may throw light upon the origin of the fat cell, regarding which there is much conflicting opinion. The writer has lately had the opportunity to examine a tumor of that type, removed from a patient in the Surgical Out-Door Department of the Peter Bent Brigham Hospital, and with the kind permission of Dr. Harvey Cushing a brief summary of the case is given. The patient, a Russian Jew, came to the hospital on November 18, 1920, complaining of a growth in his right thigh. His past history is unimportant except in so far as it concerns the tumor. In 1917 he noticed a firm swelling the size of a walnut beneath the skin on the mesial surface of the right thigh. It caused no pain. A few months later it was noticeably larger, and massage was instituted for a short time. It continued to grow slowly and became a little painful, particularly in cold weather. He was, however, able to work in his store, and he walked into the hospital.