{"id":140,"date":"2021-04-15T11:03:43","date_gmt":"2021-04-15T11:03:43","guid":{"rendered":"http:\/\/drambarishpadhee.com\/blog\/?p=140"},"modified":"2021-04-15T13:50:01","modified_gmt":"2021-04-15T13:50:01","slug":"infiltrative-liposarcoma-v-s-primary-recurrent-liposarcoma","status":"publish","type":"post","link":"https:\/\/drambarishpadhee.com\/blog\/infiltrative-liposarcoma-v-s-primary-recurrent-liposarcoma\/","title":{"rendered":"Infiltrative Liposarcoma V\/S Primary recurrent Liposarcoma"},"content":{"rendered":"\n

Clinical Information <\/p>\n\n\n\n

Subcutaneous chest wall mass with radiological evidence of erosion of the 8th rib inferio- posteriorly operated at Breach Candy Hospital Mumbai in 2000<\/p>\n\n\n\n

Excised tissue  reported as Liposarcoma with free resected margins <\/p>\n\n\n\n

Post operative radiotherapy was instituted <\/p>\n\n\n\n

Radiological sequential followup neither show evidence of any lung parenchymal involvement,  nor  any distant metastasis. <\/p>\n\n\n\n

The patient had a similar lesion in 2008 at the back of the neck deep to trapezius rhomboid and para spinal muscle and histoplically diagnosed as a benign Lipoma. <\/p>\n\n\n\n

Presently in 2021 , patient was evaluated for chest pain and dyspnoea at Fortis Hospital Bangalore <\/p>\n\n\n\n

CECT : Extensive pleural nodules <\/p>\n\n\n\n

PET CT : Pleural nodules <\/p>\n\n\n\n

Trucut Needle biopsy:  Liposarcoma: ? Infiltratrative Liposarcoma ? Recurrent primary Liposarcoma Vimentin + MDM2 + <\/p>\n\n\n\n

The surgical oncologist consider the feasibility of parietal pleurectomy +_ decortication. <\/p>\n\n\n\n

However the technical surgical limitations for the pleural involvement & expected effective surgical outcome , the possibility of medical oncology support for latest chemotherapy radiotherapy targeted immunotherapy for Liposarcoma was sought for <\/p>\n\n\n\n

The whole scanned slide was reviewed , upon a personal request , by Elizabeth Anne Montgomery, MD Professor of Pathology, Vice Chair, Anatomic Pathology, University of Miami Miller School of Medicine upon a personal request. <\/p>\n\n\n\n

She feels that the findings are reasonable for sclerosing well-diff liposarcoma, but the imaging suggests several nodules, wondering if the sampling missed an overt dedifferentiated component.<\/p>\n\n\n\n

The biopsy was reviewed by Dr Anita Borges and the IHC markers were not supportive . The IHC for Cytokeratin , CK 8\/18, EMA, S100, CDK4, CD34, WT1, D240, Calretinin , Desmin and MDM 2 were negative . Weak SMA + detected . <\/p>\n\n\n\n

The histological differential was between a Metastatic Liposarcoma and Sarcomatous Mesothelioma <\/p>\n\n\n\n

A repeat biopsy is being reviewed and report is awaited\u00a0<\/p>\n\n\n\n

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