Beyond the benign: A rare case report of myxoid pleomorphic liposarcoma

Abstract

Myxoid pleomorphic liposarcoma is a rare and aggressive subtype of soft tissue sarcomas (STS). It primarily arises from adipose tissue and exhibits a high rate of recurrence and metastatic potential. We report the case of a 35-year-old male gym trainer with a 5-month history of a painless, progressively enlarging mass on the right posterior aspect of chest, diagnosed with myxoid pleomorphic liposarcoma following imaging and histopathological evaluation of the excised specimen. Surgical excision with clear margins and adjuvant radiotherapy resulted in a favorable outcome with no recurrence at 7 months. This case emphasizes the importance of early diagnosis and multidisciplinary approach in managing a rare soft tissue sarcoma to prevent complications from a delayed intervention.

Keywords: Case report; Myxoid pleomorphic liposarcoma; Oncology; Soft tissue sarcoma.

Fig. 1

Preoperative picture showing a swelling location on the right side of back of chest, with lateralization on over-head abduction of the right arm.

Fig. 2

CT films show a right sided mass lesion (arrowhead) in the intermuscular plane deep to latissimus dorsi muscle located lateral to, and extending inferiorly from the scapula. Underlying bone is unremarkable.

Fig. 3

histological images of the Tru-Cut biopsy showing spindle cells with ovoid nuclei with tapering eosinophilic cytoplasm.

Fig. 4

MRI Rt. Shoulder shows a well-defined lobulated heterogenous looking altered signal intensity lesion on T2WI/STIR; first row (axial), second row: left (coronal), right (sagittal).

Fig. 5

MRI Rt. Shoulder shows mass lesion signals isointense to muscles on T1W1/FSE (first row, axial; second row, coronal), with postcontrast enhancement (third row: left, axial; right, coronal). Further, signal void of vessels is unremarkable.

Fig. 6

Intraoperative picture showing excised lesion.