Table of Contents Author Guidelines Submit a Manuscript
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.

Linked References

  1. D. C. Dahlin and J. W. Beabout, “Dedifferentiation of low-grade chondrosarcomas,” Cancer, vol. 28, no. 2, pp. 461–466, 1971. View at Publisher · View at Google Scholar
  2. J. Rosai, “Current concepts of dedifferentiation in soft tissue and bone sarcomas,” in Proceedings of the Annual Meeting of the International Society of Bone and Soft Tissue Pathology, San Antonio, Tex, USA, February-March 2005.
  3. F. M. Enzinger and D. J. Winslow, “Liposarcoma: a study of 103 cases,” Virchows Archiv, vol. 335, no. 4, pp. 367–388, 1962. View at Publisher · View at Google Scholar
  4. L. G. Kindblom, L. Angervall, and P. Svendsen, “Liposarcoma a clinicopathologic, radiographic and prognostic study,” Acta Pathologica et Microbiologica Scandinavica, no. 253, pp. 1–71, 1975. View at Google Scholar
  5. H. L. Evans, “Liposarcoma: a study of 55 cases with a reassessment of its classification,” The American Journal of Surgical Pathology, vol. 3, no. 6, pp. 507–523, 1979. View at Google Scholar
  6. S. W. Weiss and V. K. Rao, “Well-differentiated liposarcoma (atypical lipoma) of deep soft tissue of the extremities, retroperitoneum, and miscellaneous sites: a follow-up study of 92 cases with analysis of the incidence of “dedifferentiation”,” The American Journal of Surgical Pathology, vol. 16, no. 11, pp. 1051–1058, 1992. View at Google Scholar
  7. J.-M. Coindre, O. Mariani, F. Chibon et al., “Most malignant fibrous histiocytomas developed in the retroperitoneum are dedifferentiated liposarcomas: a review of 25 cases initially diagnosed as malignant fibrous histiocytoma,” Modern Pathology, vol. 16, no. 3, pp. 256–262, 2003. View at Publisher · View at Google Scholar · View at PubMed
  8. W. H. Henricks, Y. C. Chu, J. R. Goldblum, and S. W. Weiss, “Dedifferentiated liposarcoma: a clinicopathological analysis of 155 cases with a proposal for an expanded definition of dedifferentiation,” The American Journal of Surgical Pathology, vol. 21, no. 3, pp. 271–281, 1997. View at Publisher · View at Google Scholar
  9. D. McCormick, T. Mentzel, A. Beham, and C. D. M. Fletcher, “Dedifferentiated liposarcoma: clinicopathologic analysis of 32 cases suggesting a better prognostic subgroup among pleomorphic sarcomas,” The American Journal of Surgical Pathology, vol. 18, no. 12, pp. 1213–1223, 1994. View at Google Scholar
  10. F. Elgar and J. R. Goldblum, “Well-differentiated liposarcoma of the retroperitoneum: a clinicopathologic analysis of 20 cases, with particular attention to the extent of low-grade dedifferentiation,” Modern Pathology, vol. 10, no. 2, pp. 113–120, 1997. View at Google Scholar
  11. H. L. Evans, “Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years,” The American Journal of Surgical Pathology, vol. 31, no. 1, pp. 1–14, 2007. View at Publisher · View at Google Scholar · View at PubMed
  12. C. Kuhnen, T. Mentzel, R. Sciot, M. Lehnhardt, H.-H. Homann, and M. Debiec-Rychter, “Dedifferentiated liposarcoma with extensive lymphoid component,” Pathology Research and Practice, vol. 201, no. 4, pp. 347–353, 2005. View at Publisher · View at Google Scholar
  13. J. C. Fanburg-Smith and M. Miettinen, “Liposarcoma with meningothelial-like whorls: a study of 17 cases of a distinctive histological pattern associated with dedifferentiated liposarcoma,” Histopathology, vol. 33, no. 5, pp. 414–424, 1998. View at Publisher · View at Google Scholar
  14. A. G. Nascimento, P. J. Kurtin, L. Guillou, and C. D. M. Fletcher, “Dedifferentiated liposarcoma: a report of nine cases with a peculiar neurallike whorling pattern associated with metaplastic bone formation,” The American Journal of Surgical Pathology, vol. 22, no. 8, pp. 945–955, 1998. View at Publisher · View at Google Scholar
  15. R. P. Salzano, Jr., Z. Tomkiewicz, and W. A. Africano, “Dedifferentiated liposarcoma with features of rhabdomyosarcoma,” Connecticut Medicine, vol. 55, no. 4, pp. 200–202, 1991. View at Google Scholar
  16. H. L. Evans, K. K. Khurana, B. L. Kemp, and A. G. Ayala, “Heterologous elements in the dedifferentiated component of dedifferentiated liposarcoma,” The American Journal of Surgical Pathology, vol. 18, no. 11, pp. 1150–1157, 1994. View at Google Scholar
  17. G. Tallini, R. A. Erlandson, M. F. Brennan, and J. M. Woodruff, “Divergent myosarcomatous differentiation in retroperitoneal liposarcoma,” The American Journal of Surgical Pathology, vol. 17, no. 6, pp. 546–556, 1993. View at Google Scholar
  18. T. Hasegawa, K. Seki, F. Hasegawa et al., “Dedifferentiated liposarcoma of retroperitoneum and mesentery: varied growth patterns and histological grades—a clinicopathologic study of 32 cases,” Human Pathology, vol. 31, no. 6, pp. 717–727, 2000. View at Publisher · View at Google Scholar
  19. S. Shimada, T. Ishizawa, K. Ishizawa, K. Kamada, and T. Hirose, “Dedifferentiated liposarcoma with rhabdomyoblastic differentiation,” Virchows Archiv, vol. 447, no. 5, pp. 835–841, 2005. View at Publisher · View at Google Scholar · View at PubMed
  20. S. Pilotti, A. Mezzelani, B. Vergani et al., “Morphologic-cytogenetic analysis of dedifferentiated liposarcomas with an extensive misleading leiomyosarcomatous component,” Applied Immunohistochemistry and Molecular Morphology, vol. 8, no. 3, pp. 216–221, 2000. View at Publisher · View at Google Scholar
  21. H. L. Evans, “Smooth muscle in atypical lipomatous tumors. A report of three cases,” The American Journal of Surgical Pathology, vol. 14, no. 8, pp. 714–718, 1990. View at Google Scholar
  22. S. Suster, T.-Y. Wong, and C. A. Moran, “Sarcomas with combined features of liposarcoma and leiomyosarcoma: study of two cases of an unusual soft-tissue tumor showing dual lineage differentiation,” The American Journal of Surgical Pathology, vol. 17, no. 9, pp. 905–911, 1993. View at Google Scholar
  23. A. L. Folpe and S. W. Weiss, “Lipoleiomyosarcoma (well-differentiated liposarcoma with leiomyosarcomatous differentiation): a clinicopathologic study of nine cases including one with dedifferentiation,” The American Journal of Surgical Pathology, vol. 26, no. 6, pp. 742–749, 2002. View at Publisher · View at Google Scholar
  24. D. Govender and P. Pillay, “Primary myxoid liposarcoma with rhabdomyoblastic differentiation,” Archives of Pathology and Laboratory Medicine, vol. 122, no. 8, pp. 740–742, 1998. View at Google Scholar
  25. M. B. N. Binh, L. Guillou, I. Hostein et al., “Dedifferentiated liposarcomas with divergent myosarcomatous differentiation developed in the internal trunk: a study of 27 cases and comparison to conventional dedifferentiated liposarcomas and leiomyosarcomas,” The American Journal of Surgical Pathology, vol. 31, no. 10, pp. 1557–1566, 2007. View at Google Scholar
  26. V. C. Stevens, “Human chorionic gonadotrophin: properties and potential immunological manipulation for clinical application,” Clinics in Obstetrics and Gynaecology, vol. 6, no. 3, pp. 549–566, 1979. View at Google Scholar
  27. A. J. Lapthorn, D. C. Harris, A. Littlejohn et al., “Crystal structure of human chorionic gonadotropin,” Nature, vol. 369, no. 6480, pp. 455–461, 1994. View at Publisher · View at Google Scholar · View at PubMed
  28. S. Gailani, T. M. Chu, A. Nussbaum, M. Ostrander, and N. Christoff, “Human chorionic gonadotrophins (hCG) in nontrophoblastic neoplasms. Assessment of abnormalities of hCG and CEA in bronchogenic and digestive neoplasms,” Cancer, vol. 38, no. 4, pp. 1684–1686, 1976. View at Publisher · View at Google Scholar
  29. R. K. Iles, “Ectopic hCGβ expression by epithelial cancer: malignant behaviour, metastasis and inhibition of tumor cell apoptosis,” Molecular and Cellular Endocrinology, vol. 260–262, pp. 264–270, 2007. View at Publisher · View at Google Scholar · View at PubMed
  30. M. T. Sheaff, J. E. Martin, D. F. Badenoch, and S. I. Baithun, “βhCG as a prognostic marker in adenocarcinoma of the prostate,” Journal of Clinical Pathology, vol. 49, no. 4, pp. 329–332, 1996. View at Publisher · View at Google Scholar
  31. A. Kido, M. Mori, Y. Adachi, H. Yukaya, T. Ishida, and K. Sugimachi, “Immunohistochemical expression of β-human chorionic gonadotropin in colorectal carcinoma,” Surgery Today, vol. 26, no. 12, pp. 966–970, 1996. View at Publisher · View at Google Scholar
  32. M. Szturmowicz, E. Wiatr, A. Sakowicz et al., “The role of human chorionic gonadotropin β subunit elevation in small-cell lung cancer patients,” Journal of Cancer Research and Clinical Oncology, vol. 121, no. 5, pp. 309–312, 1995. View at Publisher · View at Google Scholar
  33. G. Moutzouris, D. Yannopoulos, C. Barbatis, A. Zaharof, and C. Theodorou, “Is β-human chorionic gonadotrophin production by transitional cell carcinoma of the bladder a marker of aggressive disease and resistance to radiotherapy?,” British Journal of Urology, vol. 72, no. 6, pp. 907–909, 1993. View at Google Scholar
  34. N. G. Ordonez, A. G. Ayala, A. K. Raymond, C. Plager, R. S. Benjamin, and N. A. Samaan, “Ectopic production of the β-subunit of human chorionic gonadotropin in osteosarcoma,” Archives of Pathology and Laboratory Medicine, vol. 113, no. 4, pp. 416–419, 1989. View at Google Scholar
  35. J. K. Kalra, R. Mir, L. B. Kahn, Z. Wessely, and A. B. Shah, “Osteogenic sarcoma producing human chorionic gonadotrophin. Case report with immunohistochemical studies,” Cancer, vol. 53, no. 10, pp. 2125–2128, 1984. View at Publisher · View at Google Scholar
  36. B. Leidinger, S. Bielack, G. Koehler, V. Vieth, W. Winkelmann, and G. Gosheger, “High level of β-hCG simulating pregnancy in recurrent osteosarcoma: case report and review of literature,” Journal of Cancer Research and Clinical Oncology, vol. 130, no. 6, pp. 357–361, 2004. View at Publisher · View at Google Scholar · View at PubMed
  37. G. R. Mack, D. B. Robey, and R. J. Kurman, “Chondrosarcoma secreting chorionic gonadotropin: report of a case,” Journal of Bone and Joint Surgery, vol. 59, no. 8, pp. 1107–1111, 1977. View at Google Scholar
  38. R. F. Meredith, L. D. Wagman, J. A. Piper, A. S. Mills, and J. P. Neifeld, “β-chain human chorionic gonadotropin-producing leiomyosarcoma of the small intestine,” Cancer, vol. 58, no. 1, pp. 131–135, 1986. View at Publisher · View at Google Scholar
  39. C. Seidl, C. Lippert, V. Grouls, and W. Jellinghaus, “Leiomyosarcoma of the spermatic cord with paraneoplastic β-hCG production,” Pathologe, vol. 19, no. 2, pp. 146–150, 1998. View at Publisher · View at Google Scholar
  40. S. Liang, G. Stone, E. Chalas, M. Pearl, F. Callan, and W. Zheng, “A high-grade uterine leiomyosarcoma with human chorionic gonadotropin production,” International Journal of Gynecological Pathology, vol. 25, no. 3, pp. 257–261, 2006. View at Publisher · View at Google Scholar · View at PubMed
  41. S.-M. Ou, S.-S. Lee, Y.-J. Peng, L.-F. Sheu, N.-S. Yao, and S.-Y. Chang, “Production of β-hCG by spermatic cord leiomyosarcoma: a paraneoplastic syndrome?,” Journal of Andrology, vol. 27, no. 5, pp. 643–644, 2006. View at Publisher · View at Google Scholar · View at PubMed
  42. I. A. Mansi, I. Ashley, and V. Glezerov, “Retroperitoneal leiomyosarcoma and enlarged epididymis associated with a positive pregnancy test,” The American Journal of the Medical Sciences, vol. 324, no. 2, pp. 104–105, 2002. View at Publisher · View at Google Scholar
  43. M. P. Froehner, H.-J. Gaertner, A. Manseck, S. Oehlschlaeger, and M. P. Wirth, “Retroperitoneal leiomyosarcoma associated with an elevated β-hCG serum level mimicking extragonadal germ cell tumor,” Sarcoma, vol. 4, no. 4, pp. 179–181, 2000. View at Publisher · View at Google Scholar · View at PubMed
  44. M. B. N. Binh, X. Sastre-Garau, L. Guillou et al., “MDM2 and CDK4 immunostainings are useful adjuncts in diagnosing well-differentiated and dedifferentiated liposarcoma subtypes: a comparative analysis of 559 soft tissue neoplasms with genetic data,” The American Journal of Surgical Pathology, vol. 29, no. 10, pp. 1340–1347, 2005. View at Publisher · View at Google Scholar