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Case Reports
. 2018 Jul 16:2018:1708572.
doi: 10.1155/2018/1708572. eCollection 2018.

Spinal Metastasis of Well-Differentiated Liposarcoma Component in Retroperitoneal Dedifferentiated Liposarcoma Treated by Minimally Invasive Surgery

Jiro Ichikawa  1 , Tetsuro Ohba  1 , Hiroaki Kanda  2 , Koji Fujita  1 , Shigeto Ebata  1 , Hirotaka Haro  1
Affiliations
Case Reports

Spinal Metastasis of Well-Differentiated Liposarcoma Component in Retroperitoneal Dedifferentiated Liposarcoma Treated by Minimally Invasive Surgery

Jiro Ichikawa et al. Case Rep Orthop. .

Abstract

Case: Generally, well-differentiated liposarcoma (WDL) has recurrence potential but lacks metastatic potential. We present a rare case of spinal metastasis of WDL component in retroperitoneal dedifferentiated liposarcoma (DDL) treated by tumor curettage and L1 laminectomy followed by percutaneous pedicle screw fixation. Histological examination showed metastasis of the WDL component of DDL. The patient was ambulatory until death.

Conclusion: To our knowledge, no case of spinal metastasis of WDL component in retroperitoneal DDL has been reported. We should carefully consider characteristics of DDLs during treatment. Minimally invasive surgery may be a powerful tool in patients with spinal metastasis.

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Figures

Figure 1
Figure 1
Abdominal computed tomography (CT). (a) Enhanced CT prior to the first surgery showed a large retroperitoneal mass in the second lumbar vertebra level, which consisted of both lipomatous (yellow asterisk) and nonlipomatous (red asterisk) components. Plain CT at 8 months (b) and 3 months (c) before our first visit showed metastatic lipomatous component (red arrow) involved in the vertebral body. (d, e) CT findings at our first visit showed both lipomatous (yellow asterisk) and nonlipomatous (red asterisk) components; in addition, the metastatic lipomatous component in the vertebral body had increased and destroyed the vertebral body. Magnetic resonance image of the lumbar spine. Axial T1-weighted (f), T2-weighted (g), and enhanced T1-weighted images (h) showed the mass with a similar intensity to fat and widespread from the vertebral body to the canal space (yellow arrow).
Figure 2
Figure 2
Postoperative radiograph of the anteroposterior view (a) and lateral view (b).
Figure 3
Figure 3
Histology of the primary site-dedifferentiated liposarcoma (a, b) and well-differentiated liposarcoma components (c, d) and the metastasis (e, f). (a, c, e) Hematoxylin-eosin stain. (b, d, f) Immunohistochemistry of MDM2. There was a mixed well-differentiated and dedifferentiated component in the primary lesion (a, c). Only the well-differentiated component was seen in the spine metastasis (e). Bar = 50 μm.
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