Myxoid liposarcoma in a 91-year-old patient

Abstract

Background: Myxoid liposarcoma is a mesenchymal malignancy most commonly presenting in young adults. This tumor is known for its characteristic chromosomal rearrangement at the DDIT3 locus.

Results: We report a case of myxoid liposarcoma in a 91-year-old, the oldest known patient with this disease-entity. FISH analysis of the DDIT3 and FUS loci demonstrate the pathognomonic chromosomal alteration in the setting of predominantly round cell histology on biopsy, confirmed by RT-PCR.

Conclusion: Myxoid liposarcoma affects mostly young adults but can be seen in the elderly population. Molecular and cytogenetic assays are helpful auxiliaries to histology in the setting of unusual histology and clinical presentation.

Figure 1

Abdomino-pelvic CT scan showing tumor in the left medial thigh (*).

Figure 2

Core needle biopsy of mass. (a) 20× H&E section showing hypercellularity, and lacking any differentiated morphology. (b) and (c) Fluorescent photomicrographs showing biopsied tumor cells hybridized to commercial break-apart probes specific to the DDIT3(b) and FUS(c) loci. Probes flank targeted gene sequence showing yellow signal when bound in proximity (intact locus) and showing individual red and or green signals when bound in isolation (rearranged locus). EWSR1 (not shown) was conversely intact with two paired (yellow) signals per nucleus.

Figure 3

Excision of mass. Gross photo showing 19 cm yellow, hemorrhagic mass (a), featuring regions with typical myxoid liposarcoma, 10× H&E (b), and typical chicken-wire vasculature highlighted by CD31 immunohistochemical stain (c).