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Isolation and Characterization of Tumor-initiating Cells from Sarcoma Patient-derived Xenografts
Published on: June 13, 2019
Dedifferentiated liposarcoma with inflammatory myofibroblastic tumor-like features
David R Lucas1, Abhishek Shukla, Dafydd G Thomas
1Department of Pathology, University of Michigan, Ann Arbor, MI 48109-0054, USA. drlucas@umich.edu
The American Journal of Surgical Pathology
|May 1, 2010
Summary
Dedifferentiated liposarcoma can mimic inflammatory myofibroblastic tumor, presenting diagnostic challenges. Recognizing these features is crucial to avoid misdiagnosis and ensure appropriate patient management for this aggressive cancer.
Area of Science:
- Surgical Pathology
- Oncology
- Genitourinary Pathology
Background:
- Dedifferentiated liposarcoma (DDLS) exhibits diverse histologic features, including heterologous differentiation.
- Myofibroblastic differentiation is known in DDLS, but resemblance to inflammatory myofibroblastic tumor (IMT) is not well-documented.
Purpose of the Study:
- To report clinicopathologic, immunohistochemical, and molecular findings in six cases of DDLS with IMT-like features.
- To highlight the diagnostic challenges and aggressive behavior of these specific DDLS variants.
Main Methods:
- Retrospective review of six DDLS cases with IMT-like morphology.
- Analysis of histopathology, immunohistochemistry (smooth muscle actin, desmin, ALK-1, MDM2), and fluorescence in situ hybridization (MDM2 amplification).
Main Results:
- Tumors occurred in middle-aged to elderly men, primarily in the inguinal/scrotal region or retroperitoneum, with aggressive behavior.
- Microscopic examination revealed features indistinguishable from IMT, including myxoid, cellular, and hypocellular patterns. Nodular fasciitis or desmoid fibromatosis-like areas were common.
- All cases showed well-differentiated liposarcoma components, and five had MDM2 amplification. No cases stained positive for ALK-1.
Conclusions:
- DDLS can present with prominent IMT-like features, expanding its known histologic spectrum.
- Awareness of this mimicry is essential to prevent misdiagnosis of DDLS as IMT, which has a significantly better prognosis.
- These aggressive tumors frequently recurred or metastasized, with significant patient morbidity and mortality.
