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Updated: Mar 24, 2026

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Liposarcoma masquerading as an inflammatory pseudotumor: a case report.

Jessica J H Reagh1, Robert P Eckstein1, Christina I Selinger2

  • 1Department of Anatomical Pathology, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW, 2065, Australia.

Journal of Medical Case Reports
|March 19, 2016
PubMed
Summary

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MDM2 amplification testing can help differentiate fibrosing inflammatory pseudotumor from well-differentiated liposarcoma. This study shows MDM2 amplification in a case initially misdiagnosed as pseudotumor, later recurring as sarcoma.

Area of Science:

  • Oncology
  • Pathology
  • Genetics

Background:

  • Differentiating atypical lipomatous tumors/well-differentiated liposarcoma from benign lipomatous tumors solely on morphology is challenging.
  • MDM2 fluorescent in situ hybridization (FISH) is established for this differential diagnosis.
  • Literature is lacking on MDM2 FISH for distinguishing well-differentiated liposarcoma with extreme fibrosis from fibrosing inflammatory pseudotumor.

Observation:

  • A 76-year-old woman was initially diagnosed with a retroperitoneal fibrosing inflammatory pseudotumor via excision biopsy.
  • Five years later, she developed a pleomorphic undifferentiated sarcoma.
  • Review of the original specimen revealed MDM2 amplification, also present in adjacent adipose tissue and the recurrent sarcoma.

Findings:

Keywords:
Benign lipomatous tumorLiposarcomaMDM2

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  • MDM2 amplification was detected in the retroperitoneal tumor.
  • The findings suggest the initial diagnosis of fibrosing inflammatory pseudotumor was incorrect.
  • The recurrent pleomorphic undifferentiated sarcoma demonstrated MDM2 amplification.

    • Implications:

    • This case provides strong evidence that the original tumor was a misdiagnosed well-differentiated liposarcoma with extreme fibrosis.
    • The pleomorphic undifferentiated sarcoma likely represented dedifferentiation and recurrence of the liposarcoma.
    • MDM2 amplification testing is crucial for accurate diagnosis and management of challenging lipomatous tumors.