Hypopharyngeal Dedifferentiated Liposarcoma in the MDM2 Era: A Case Report and Short Review

Abstract

Pharyngeal liposarcomas are very rare; still more rare are dedifferentiated liposarcomas in the pharynx. An 82-year-old man presented with dysphagia, voice changes, weight loss, nasal regurgitation of liquids, and coughing spells. A 3.5 cm mass was identified in the hypopharynx. The mass was biopsied and diagnosed as a benign fibroepithelial polyp. Continued symptoms and airway obstruction prompted a pharyngectomy, and the mass was then diagnosed as dedifferentiated liposarcoma. Due to infrequency and subtle histological findings, liposarcomas of the head and neck can be misdiagnosed and recur.

Figure 1

CT angiogram of neck ((a) coronal, (b) axial) demonstrating a 3.5 cm heterogeneous lesion in the posterior wall of the hypopharynx in a submucosal location (i) and a smaller 1.7 cm lesion of the right posterior wall of the hypopharynx (ii). The mass caused severe narrowing of the air column at the hypopharynx (iii).

Figure 2

(a) Dedifferentiated liposarcoma, solid fascicles of spindle cells with eosinophilic cytoplasm and slightly enlarged nuclei; (b) well-differentiated area, adipocytes, and lipoblasts with enlarged, hyperchromatic nuclei and multivacuolated cytoplasm (hematoxylin and eosin, 200x magnification).