Abstract
Abdominal liposarcoma is most often located in the retroperitoneum. Small bowel mesentery is a rare site of liposarcoma. Dedifferentiated liposarcoma (DDLS) is a rare variant of mesenteric liposarcoma with only 12 cases reported in the literature. DDLS has a worse prognosis compared to a well-differentiated liposarcoma. Here, we present a case of giant liposarcoma located in the jejunal mesentery diagnosed on the contrast-enhanced computed tomography of the abdomen. The patient underwent complete surgical excision with uneventful postoperative recovery. DDLS was confirmed on histopathological examination of the resected specimen. The patient is currently receiving adjuvant therapy with doxorubicin and ifosfamide in view of close resection margin, mitotic rate and high rate of recurrence.
Highlights
Liposarcoma is one of the commonest soft tissue sarcomas in adults
Dedifferentiated liposarcoma (DDLS) is a rare variant of mesenteric liposarcoma with only 12 cases reported in the literature
We report a rare case of multifocal dedifferentiated liposarcoma (DDLS) located in the jejunal mesentery treated successfully by complete surgical excision and adjuvant chemotherapy
Summary
Liposarcoma is one of the commonest soft tissue sarcomas in adults. It is most often seen in the soft tissues of the extremities and retroperitoneum. DDLS consists of two components - atypical lipomatous tumor/welldifferentiated liposarcoma and high-grade non-lipogenic sarcoma. It most commonly occurs in the retroperitoneum. We report a rare case of multifocal DDLS located in the jejunal mesentery treated successfully by complete surgical excision and adjuvant chemotherapy. Two small separate nodules were seen abutting the bowel wall (Figure 2 inset). These nodules showed spindle cell sarcomatous areas (Figure 3C). The dedifferentiated areas in both the large and small nodules were positive for CDK4 and MDM2 while negative for CD117, DOG1, CD34, SMA, desmin and S100 on the immunohistochemical analysis (Figures 3D-3F). At the last follow-up two months after surgery, the patient is doing well without any recurrence and receiving adjuvant therapy with ifosfamide and doxorubicin in view of high risk of recurrence
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