Metastatic Myxoid Liposarcoma Research Articles

Metastatic Myxoid Liposarcoma on the Upper Thoracic Spine Treated with a Less Invasive Technique

Liposarcoma, a common soft-tissue sarcoma, includes myxoid liposarcoma (MLS) as its second-most frequent subtype. MLS primarily affects the thigh region during the fourth to fifth decades of life and often metastasizes to the spine. Managing spinal metastases is complex, with pedicle screw anchoring strength being a key concern. Various techniques address this issue, including the use of exoskeleton cement with polymethylmethacrylate (PMMA). We present a case of a 37-year-old male with MLS metastatic to the spine, experiencing lower-extremity weakness despite prior tumor excision and chemotherapy. Posterior decompression and fusion were performed, revealing inadequate screw anchoring. To address this, we applied exoskeleton cement with PMMA, resulting in improved pain but limited motor and sensory recovery. Spinal metastases, especially in the context of liposarcoma, significantly impact patient well-being. Surgical resection remains the primary treatment, but challenges arise due to tumor size and anatomical complexities. Bone mineral density (BMD) and pedicle screw stability are closely related, emphasizing the importance of addressing BMD-related issues in surgical planning. Augmented cement, such as PMMA, can enhance screw anchoring, but the risk of cement leakage must be considered. Exoskeleton cement is a promising technique but necessitates further research for comprehensive evaluation and refinement. In conclusion, the rise in spinal metastatic disease underscores the need for effective management strategies. MLS’s propensity to metastasize to the spine highlights the importance of tailored treatment approaches. Techniques like exoskeleton cement show promise in addressing screw anchoring issues but require additional investigation.

Laparoscopic resection of a metastatic myxoid liposarcoma in the mesentery of the small intestine: a case report

BackgroundMyxoid liposarcoma (MLS), with its risk factors, tends to spread to the lungs and extraperitoneally, with intraperitoneal metastases occurring rarely. We present an unusual case of a myxoid liposarcoma that metastasized to the abdominal organs.Case presentationA 60-year-old female patient was referred to our hospital for the evaluation of a right upper limb tumor that had been growing for 7 years. The patient refused surgery, and during follow-up, tumor hemorrhage resulted in hemorrhagic shock. The patient’s right upper limb was immediately amputated. MLS was diagnosed histopathologically. Subsequently, the patient underwent adjuvant chemotherapy. Computed tomography (CT) revealed a right buttock mass, a pelvic mass, and left cardiophrenic angle lymph nodes 3 years after the initial surgery. Contrast-enhanced abdominal CT revealed a relatively low-density, lobulated pelvic tumor. Contrast-enhanced pelvic magnetic resonance imaging (MRI) revealed a low-intensity, lobulated mass on T1-weighted images and a high-intensity mass on T2-weighted images. The pelvic mass showed no significant fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)-CT. On clinical examination, gynecological malignancies were ruled out as the origin of the pelvic lesions. After resection of the right buttock mass, pelvic mass, and left cardiophrenic angle lymph nodes, the patient underwent laparoscopic surgery for a preoperative diagnosis of small intestinal mesenteric metastasis of MLS. A tumor was found in the mesentery of the small intestine and removed with a margin of 5 cm on both the proximal and distal sides. The specimen measured 10 × 8 × 5 cm and contained a multifocal mass. The tumor was found in the mesentery of the small intestine, with no mucosal or submucosal invasion. The patient was diagnosed with MLS with small mesenteric intestinal metastases. On postoperative day 8, the patient was discharged after an uneventful postoperative course. Twelve months after the surgery, there was no evidence of local or distant recurrence.ConclusionsSmall intestinal mesenteric metastases of MLSs are rare. Moreover, there are few reports on laparoscopic resection. In this case, the laparoscopic approach was useful in detecting the tumor location and determining the range of resection.

Long-Term Control of Metastatic Myxoid Liposarcoma of the Thigh with Palliative Trabectedin: A Case Report

Long-Term Control of Metastatic Myxoid Liposarcoma of the Thigh with Palliative Trabectedin: A Case Report

Different HSP90 Inhibitors Exert Divergent Effect on Myxoid Liposarcoma In Vitro and In Vivo

The therapeutic options for patients with relapsed or metastatic myxoid liposarcoma (MLS) remain scarce and there is currently no targeted therapy available. Inhibition of the HSP90 family of chaperones has been suggested as a possible therapeutic option for patients with MLS. However, the clinical effect of different HSP90 inhibitors vary considerably and no comparative study in MLS has been performed. Here, we evaluated the effects of the HSP90 inhibitors 17-DMAG, AUY922 and STA-9090 on MLS cell lines and in an MLS patient-derived xenograft (PDX) model. Albeit all drugs inhibited in vitro growth of MLS cell lines, the in vivo responses were discrepant. Whereas 17-DMAG inhibited tumor growth, AUY922 surprisingly led to increased tumor growth and a more aggressive morphological phenotype. In vitro, 17-DMAG and STA-9090 reduced the activity of the MAPK and PI3K/AKT signaling pathways, whereas AUY922 led to a compensatory upregulation of downstream ERK. Furthermore, all three tested HSP90 inhibitors displayed a synergistic combination effect with trabectidin, but not with doxorubicin. In conclusion, our results indicate that different HSP90 inhibitors, albeit having the same target, can vary significantly in downstream effects and treatment outcomes. These results should be considered before proceeding into clinical trials against MLS or other malignancies.

Robotic hand port assisted resection of liver and peritoneal metastases in patient with high-grade myxoid liposarcoma

Presenter: Karolin Ginting MD | The Jewish Hospital Background: Extremity soft tissue sarcomas, especially with the myxoid subtype, have a propensity to metastasize to extrapulmonary sites. Among these patients, metastasis to the liver is relatively rare and usually presents in a single site. Methods: We presented a 41-year-old severely obese woman (BMI: 40) with a history of high-grade myxoid liposarcoma of the left thigh presents with liver and peritoneal masses found on surveillance CT scan. Core biopsy showed evidence of metastatic poorly differentiated myxoid liposarcoma. After further discussion during interdisciplinary tumor board conference, surgical resection and adjuvant chemotherapy were recommended. Results: Adequate intraoperative examination and mobilization of these masses was expected to be challenging due to patient habitus, prompting a decision to proceed surgery with robotic and hand-port assisted technique. During diagnostic laparoscopy and intraoperative ultrasound study, two small liver masses in segment IVa and the right liver, and a peritoneal nodule were noted. Complete excisions of these masses were done under ultrasonography guidance. The postoperative course was unremarkable, and the patient was discharged home on day five without complication. Final pathology of both the peritoneal nodule and the largest liver mass showed R0 resection of metastatic myxoid liposarcoma and confirm benignancy of the two smaller number masses. Conclusion: Successful resection and outcome were achieved through a multidisciplinary approach including medical oncology, surgical oncology, radiology and pathology. Further research into survival benefits of resection, as well as the use of radiation or chemotherapy as an adjuvant treatment, would be beneficial in enabling physicians to better understand the available choices further patients, and to generate more valuable decision-making discussions.

Solitary metastasis of myxoid liposarcoma from the thigh to intraperitoneum: a case report

BackgroundThe purpose of case report was to present a rare case of a solitary metastasis of myxoid liposarcoma and discuss the clinical and pathological information for patients treated for metastatic myxoid liposarcoma.Case presentationWe report our experience with a case of solitary metastasis of myxoid liposarcoma from the thigh to intraperitoneum. The patient was a 60-year-old man who was referred for abdominal discomfort and fatigue. Enhanced computed tomography showed a 25-cm intra-abdominal tumor. He had undergone a wide local excision for a right thigh myxoid liposarcoma 6 years earlier. At laparotomy, a huge multi-lobular cystic mass was identified at the small bowel mesentery. Wide local excision was performed, and the mass was diagnosed as metastatic myxoid liposarcoma. He was discharged without postoperative complications.ConclusionsWe experienced a single intraperitoneal metastasis in a patient with myxoid liposarcoma after radical surgery of the primary site.

Calreticulin as A Novel Potential Metastasis-Associated Protein in Myxoid Liposarcoma, as Revealed by Two-Dimensional Difference Gel Electrophoresis.

Myxoid liposarcoma (MLS) is a mesenchymal malignancy. To identify innovate seeds for clinical applications, we examined the proteomes of primary tumor tissues from 10 patients with MLS with different statuses of postoperative metastasis. The protein expression profiles of tumor tissues were created, and proteins with differential expression associated with postoperative metastasis were identified by two-dimensional difference gel electrophoresis (2D-DIGE) and mass spectrometry. The validation was performed using specific antibodies and in vitro analyses. Using 2D-DIGE, we observed 1726 protein species and identified proteins with unique expression levels in metastatic MLS. We focused on the overexpression of calreticulin in metastatic MLS. The higher expression of calreticulin was confirmed by Western blotting, and gene silencing assays demonstrated that reduced expression of calreticulin inhibited cell growth and invasion. Our findings suggested the important roles of calreticulin in MLS metastasis and supported its potential utility as a prognostic biomarker in MLS. Further investigations of the functional properties of calreticulin and other proteins identified in this study will improve our understanding of the biology of MLS and facilitate novel clinical applications.

High-Throughput Screening of Myxoid Liposarcoma Cell Lines: Survivin Is Essential for Tumor Growth

Myxoid liposarcoma (MLS) is a soft tissue sarcoma characterized by a recurrent t(12;16) translocation. Although tumors are initially radio- and chemosensitive, the management of inoperable or metastatic MLS can be challenging. Therefore, our aim was to identify novel targets for systemic therapy. We performed an in vitro high-throughput drug screen using three MLS cell lines (402091, 1765092, DL-221), which were treated with 273 different drugs at four different concentrations. Cell lines and tissue microarrays were used for validation. As expected, all cell lines revealed a strong growth inhibition to conventional chemotherapeutic agents, such as anthracyclines and taxanes. A good response was observed to compounds interfering with Src and the mTOR pathway, which are known to be affected in these tumors. Moreover, BIRC5 was important for MLS survival because a strong inhibitory effect was seen at low concentration using the survivin inhibitor YM155, and siRNA for BIRC5 decreased cell viability. Immunohistochemistry revealed abundant expression of survivin restricted to the nucleus in all 32 tested primary tumor specimens. Inhibition of survivin in 402-91 and 1765-92 by YM155 increased the percentage S-phase but did not induce apoptosis, which warrants further investigation before application in the treatment of metastatic MLS. Thus, using a 273-compound drug screen, we confirmed previously identified targets (mTOR, Src) in MLS and demonstrate survivin as essential for MLS survival.

Systemic Treatment of Liposarcomas: Light at the End of the Tunnel?

Liposarcomas are one of the largest soft tissue sarcoma subgroups in adults, accounting for approximately 15%–20% of all soft tissue sarcomas. As described by Manji and Schwartz, they constitute a heterogeneous group of tumors with clinically distinct presentations, response to therapy, and prognosis. The commonest type, well-differentiated liposarcoma/ dedifferentiated liposarcoma, is characterized by a chromosomal amplification in 12q13-15, resulting in MDM2 and CDK4 overexpression. Myxoid liposarcoma has a translocation, t(12;16)(q13;p11), in greater than 90% of cases. Alterations in the PI3 kinase/AKT pathway have also been described, including mutations in PIK3CA, which are more common in round-cell tumors, and loss of the tumor suppressor gene PTEN. Activation of this pathway is demonstrated by phosphorylation of 4EBP1 and S6 downstream of mTOR. Pleomorphic liposarcoma is a subtype with a complex genetic profile and no uniformly expressed molecular alterations. The only curative option for soft tissue sarcomas is surgical excision with clear margins, and the quality of resection is an important prognostic factor for survival, especially in retroperitoneal liposarcoma. Therapeutic options are limited for patients with unresectable or metastatic disease. Chemotherapy comprising doxorubicin alone or in combination with other agents is associated with a low objective response rate withno survival benefit inwell-differentiated liposarcoma/dedifferentiated liposarcoma, whereas median survival for metastatic myxoid liposarcoma, the most chemosensitive subtype, remains limited.

Isolated Subcutaneous Metastasis of Myxoid Liposarcoma: A Case Report

Background: Subcutaneous metastatic liposarcomas are rare. Differentiation between primary tumors and metastasis of a single liposarcoma represents the main difficulty in diagnosis. In this article, we describe the first report of Subcutaneous metastasis to the neck in the right level IB from liposarcoma originating in the thigh. Case presentation: The present 19-year-old women presented to a complaint of a rapidly growing mass, of the posterior loge of the right thigh with poor definition of adjacent structures, of 9 months’ duration measuring 188 × 97 mm. Microscopic examination of the mass following excision revealed a myxoid liposarcoma. A wide surgical resection was performed, and margins were negative. At this time, the patient showed no metastatic disease and underwent a complementary treatment including irradiation of the right thigh at a dose of 50 Gy delivered in 25 fractions over 38 days. There weren’t any local recurrence or metastases on her 12 months follow up until May 2015 when she presented with a mass in the neck (right level IB). An excisional biopsy was performed by an in June 2015 revealing a myxoid liposarcoma imposing a large re-excision of the tumor bed with 3cm free tumor margin. Microscopic examination of the surgical specimen found clear margins without an involvement of the skin. Differentiation between primary tumors and metastasis of a single liposarcoma was very difficult. The results of the disease extension workup showed no sigh of other metastases no local recurrence until now. Conclusion: To our knowledge, no case of cutaneous metastatic myxoid liposarcoma has been reported until now.

Tumeurs adipeuses des glandes salivaires : étude rétrospective

Adipocytic tumors are the most common soft tissue mesenchymal tumors. Their occurrence in salivary glands is rare. We studied the epidemiology, the diagnostic and the therapeutic features of the salivary adipocytic tumors followed in our department. A retrospective study was conducted in our department between January 1997 and December 2011. Nine cases of adipocytic tumors of the salivary glands were found. Data were collected from medical records and processed by Excel. Mean age was 44 with a clear predominance of males (sex ratio: 3.5). In 8 cases the tumors were benign (7 lipomas and 1 lipofibroma). The only malignant tumor was a metastatic myxoid liposarcoma. Parotid was the main location (8 cases/9). Ultrasonography and MRI were prescribed. The treatment was tumor and parotid gland removal with conservation of the facial nerve excepted in the malignant case. One transient facial palsy, two earlobe dysesthesia and one retromandibular depression were observed. No recurrence was noted. Our study confirmed the epidemiological profile of these adipocytic salivary gland tumors, which are rarely observed, but mainly in the parotid gland. They are often benign and lipoma is the main histological type.

Trabectedin as second-line treatment in metastatic myxoid liposarcoma: a case report

IntroductionSoft tissue sarcomas are heterogeneous tumors that are difficult to treat. Up to 50 percent of patients develop metastatic disease and require systemic chemotherapy. Ifosfamide and doxorubicin are the two most active agents.Case presentationA 33-year-old Caucasian woman presented to our facility with a metastatic myxoid liposarcoma. Our patient was initially treated with surgery and radiation therapy, but experienced three recurrences during a six-year period, the first and the last occurring while our patient was pregnant. The first recurrence, which occurred two years after diagnosis and was localized in the left cervical and right axillary region, was treated with surgery followed by chemotherapy. Molecular analysis of this tumor showed a t(12,16) + translocation resulting in a FUS-DDIT3 or EWSR1-DDIT3 fusion. Three years later our patient experienced a second recurrence in the left supraclavicular fossa, upper thoracic and anterior mediastinum, which was treated with surgery alone. Eight months later, during the second pregnancy, our patient experienced a third recurrence as a large cervical mass that was treated, upon pregnancy, with trabectedin (1.5mg/m2/24-hour continuous infusion) for a total of 12 cycles. At that time a computed tomography scan showed long-term partial response with excellent treatment tolerability.ConclusionsThis case report illustrates the potential therapeutic activity of trabectedin in patients with myxoid liposarcoma.

Feasibility of Whole-body MRI for Detecting Metastatic Myxoid Liposarcoma: A Case Series

No feasible method currently exists to evaluate systemic metastasis in patients with myxoid liposarcoma. The purpose of this study was to determine the feasibility of performing whole-body magnetic resonance imaging (MRI) to detect metastatic myxoid liposarcoma. From June 2008 to May 2010, all patients who were newly diagnosed with myxoid liposarcomas at our institution underwent whole-body MRI along with other conventional imaging methods. We divided the whole body into 38 sections (7 soft tissue sections and 31 bone tissue sections). In total, there were 570 regions (105 soft tissue regions and 465 bony regions) in 15 patients (10 men and 5 women) who underwent whole-body MRI.Of 105 soft tissue regions, there were 4 true positives, 3 false positives, 1 false negative, and 97 true positives. Of 465 bone tissue regions, there were 11 true positives, 5 false positives, 2 false negatives, and 447 true negatives. In soft tissue, whole-body MRI for the detection of metastatic lesion showed a sensitivity of 80%, a specificity of 97.0%, a positive predictive value of 57.1%, and a negative predictive value of 99.0%. In bone tissue, whole-body MRI had a sensitivity of 84.6%, a specificity of 98.9%, a positive predictive value of 68.8%, and a negative predictive value of 99.6%.Whole-body MRI is feasible and effective for detecting bone and soft tissue metastasis in patients with myxoid liposarcoma.

The First Case Report of a Metastatic Myxoid Liposarcoma Invading the Left Atrial Cavity and Pulmonary Vein

Myxoid liposarcoma (MLS) is the most commonly encountered liposarcoma subgroup, accounting for about 50% of all cases. Metastatic MLS of the heart is extremely rare. Herein we describe for the first time metastasis of MLS to the left atrium and left upper pulmonary vein in a 54-year-old woman who was admitted with shortness of breath and cough persisting for 2 weeks. The patient reported that a total surgical excision of MLS of the left thigh followed by radiotherapy was performed 4 years ago. An emergency operation was performed due to rapidly progressive worsening of clinical condition and echocardiographic determination of left atrial mass protruding into the left ventricle and obstructing the mitral inflow throughout the diastole. The mass could not be totally excised because it was tightly adhered to the surrounding tissue. Postoperative magnetic resonance imaging (MRI) showed a 5 × 3 cm residual tumor deforming the posterior wall of the left atrium entirely and extending into the left upper pulmonary vein. Histopathological examination was consistent with MLS. In conclusion, considering probable cardiac metastasis in patients presenting with respiratory symptoms with medical history of soft tissue sarcomas would be life saving. The case is discussed, and a review of the literature in relation to the metastatic involvement of the heart by MLS is presented.

Metastatic myxoid liposarcoma of lung and mediastinum diagnosed by fine needle aspiration

Myxoid liposarcomas metastatic to lungs and mediastinum are infrequent lung neoplasms. The tumor has an aggressive course and needs to be recognized cytologically. A 60-year-old male smoker presented with gradually progressive left-sided chest pain, cough, and expectoration for the past one month. Chest radiograph and computed tomography of thorax revealed a lung mass in left apical region extending into the posterior mediastinum, which was subjected to ultrasound-guided fine needle aspiration (FNA). Smears showed a cellular tumor with ovoid to spindle shaped tumor cells in a myxoid background having a rich vascular network. The possibility of a myxoid liposarcoma metastatic to lung and mediastinum was suggested and confirmed by histopathology. A previous history of excision of a tumor in the thigh one and half years ago was present. The importance of recognizing the cytological picture by FNA is discussed.

Myxoid liposarcoma: A case report of a sentinel metastasis to the parotid gland with molecular confirmation

Myxoid liposarcoma is a subtype of liposarcoma with a predilection for the deep soft tissues of the extremities that accounts approximately for 10% of all adult soft tissue sarcomas. We report a case of a metastatic myxoid liposarcoma to the parotid gland, with fine-needle aspiration cytology correlation and molecular characterization. The lesion was diagnosed in a 53-year-old Hispanic male who presented with a left posterior thigh mass. A core needle biopsy established the diagnosis of myxoid liposarcoma. The patient underwent limb-sparing, wide local excision of the malignancy and later presented with an initial metastatic lesion to the parotid gland. The diagnosis of metastatic myxoid liposarcoma was rendered by fine-needle aspiration cytology with cell block preparation, and molecular confirmation. Although myxoid/round cell liposarcomas are classically described as having minimal pleomorphism on cytologic material, we encountered significant pleomorphism in our case. Therefore, a diagnosis of myxoid/round cell liposarcoma should still be a diagnostic consideration even if markedly pleomorphic cells are seen in fine-needle aspiration biopsies.

Kinome profiling of myxoid liposarcoma reveals NF-kappaB-pathway kinase activity and Casein Kinase II inhibition as a potential treatment option

BackgroundMyxoid liposarcoma is a relatively common malignant soft tissue tumor, characterized by a (12;16) translocation resulting in a FUS-DDIT3 fusion gene playing a pivotal role in its tumorigenesis. Treatment options in patients with inoperable or metastatic myxoid liposarcoma are relatively poor though being developed and new hope is growing.ResultsUsing kinome profiling and subsequent pathway analysis in two cell lines and four primary cultures of myxoid liposarcomas, all of which demonstrated a FUS-DDIT3 fusion gene including one new fusion type, we aimed at identifying new molecular targets for systemic treatment. Protein phosphorylation by activated kinases was verified by Western Blot and cell viability was measured before and after treatment of the myxoid liposarcoma cells with kinase inhibitors. We found kinases associated with the atypical nuclear factor-kappaB and Src pathways to be the most active in myxoid liposarcoma. Inhibition of Src by the small molecule tyrosine kinase inhibitor dasatinib showed only a mild effect on cell viability of myxoid liposarcoma cells. In contrast, inhibition of the nuclear factor-kappaB pathway, which is regulated by the FUS-DDIT3 fusion product, in myxoid liposarcoma cells using casein kinase 2 inhibitor 4,5,6,7-tetrabromobenzotriazole (TBB) showed a significant decrease in cell viability, decreased phosphorylation of nuclear factor-kappaB pathway proteins, and caspase 3 mediated apoptosis. Combination of dasatinib and TBB showed an enhanced effect.ConclusionKinases associated with activation of the atypical nuclear factor-kappaB and the Src pathways are the most active in myxoid liposarcoma in vitro and inhibition of nuclear factor-kappaB pathway activation by inhibiting casein kinase 2 using TBB, of which the effect is enhanced by Src inhibition using dasatinib, offers new potential therapeutic strategies for myxoid liposarcoma patients with advanced disease.

Surgery of residual disease of myxoid liposarcoma (MLS) patients responding to trabectedin.

10056 Background: Our single-institution series, now including 53 metastatic MLS patients (pts) treated with trabectedin (T), was reviewed focusing on the use of surgery of residual disease. Methods: Since September 2002, 53 pts with metastatic pretreated MLS received T. Median age at T start was 48 yrs (range 27-77). T was given as a 24-hr continuous infusion every 21 days, at a dose between 1.0 to 1.5 mg/sqm. Results: 578 courses were delivered (median = 10/pt). RECIST response rate was 50%, the median TTP was 15 months (90% CI = 9-18) and OS was 48 months. Eighteen pts stopped T on their best response (2 CR, 10 PR, 6 MR/SD): 10 remained in follow-up after a median of 11 courses and 8 underwent surgery of residual disease after a median of 12 courses. The decision whether to do surgery was based on resectability and extent of metastatic disease. Surgery was complete in all cases. Median TTP from treatment start was 30 and 25 months, respectively, in surgically and non-surgically treated pts. TTP was 14 months from treatment end in both groups. At a median follow-up of 29 months from treatment end, 13 pts relapsed (7 and 6 in the two subgroups). Twelve of these pts were rechallenged with T, obtaining 2 CR, 5 PR and 5 SD (median PFS = 14 months). Conclusions: T provides prolonged tumor control in MLS. Surgery of residual disease in responding pts is an option. However, in this small series it did not seem to provide any major advantage, in the face of a selection bias favouring in principle operated pts. T rechallenge at progression in pts who stopped their treatment on best response was associated with significant further tumor control. Prospective studies to define optimal management of MLS pts responding to T are warranted. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration PharmaMar PharmaMar PharmaMar PharmaMar PharmaMar PharmaMar

Cytogenetic evidence of metastatic myxoid liposarcoma and therapy-related myelodysplastic syndrome in a bone marrow biopsy

Myxoid liposarcoma exhibits a peculiar clinical behavior, with a tendency to spread to serosal membranes, distant soft tissues, and bones, even in the absence of lung metastases. Therapy-related hematological neoplasms are well-known side effects of cytotoxic chemotherapy. We describe an exceptional case of metastatic myxoid liposarcoma of the spine associated with therapy-related refractory anemia with excess of blasts in a 37-year-old woman who underwent multi-agent chemotherapy for a myxoid liposarcoma of the left thigh. Microscopic examination of the bone marrow biopsy revealed dysplastic features, with abnormal localization of immature precursors and micromegakaryocytes, and islands of undifferentiated oval small/medium-size cells, suggestive of acute myeloid leukemia arising in the setting of a myelodysplastic syndrome. Immunohistochemistry was not discriminant. Cytogenetic analyses of bone marrow aspirate disclosed the presence of 2 different rearrangements, subsequently confirmed by fluorescent in situ hybridization and was crucial in making the correct diagnosis.

Metastatic myxoid liposarcoma of the mandible: report of a case and review of the literature

Metastatic myxoid liposarcoma of the mandible: report of a case and review of the literature