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Sarcoma
Volume 2008 (2008), Article ID 658090, 6 pages
http://dx.doi.org/10.1155/2008/658090
Case Report

Dedifferentiated Liposarcoma of the Retroperitoneum with Extensive Leiomyosarcomatous Differentiation and 𝛽 -Human Chorionic Gonadotropin Production

1Department of Pathology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX 78236, USA
2Pathology Program, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX 78236, USA
3Department of Internal Medicine, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236, USA
4Department of Hematology/Oncology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX 78236, USA
5Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA

Received 20 August 2007; Revised 4 November 2007; Accepted 12 February 2008

Academic Editor: Cyril Fisher

Copyright © 2008 Michael J. Russell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dedifferentiated liposarcomas may display a variety of “heterologous” lines of differentiation, including osseous, vascular, skeletal, and/or smooth muscular. There have been six previously reported examples of leiomyosarcomas associated with high levels of serum human chorionic gonadotropin (hCG) production, comprised of cases originating from the retroperitoneum, spermatic cord, small intestine, and uterus. This report describes the first example of a dedifferentiated liposarcoma that combined both of the aforementioned features: extensive heterologous (leiomyosarcomatous) differentiation and 𝛽 -hCG production (maximum serum levels 1046 mIU/ml, reference < 5  mIU/ml). The tumor, which originated in the retroperitoneum in the region of the right kidney, was rapidly progressive and ultimately fatal within three months of its diagnosis. In addition to characteristic morphologic features, lipogenic and smooth muscle differentiation were confirmed with immunohistochemical stains for MDM2 and smooth muscle actin, respectively. The tumor also displayed diffuse immunoreactivity for 𝛽 -hCG in both primary and metastatic sites. This case further expands the clinicopathologic spectrum of lipogenic tumors.