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Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction.

Mohammad Al-Attar¹, Anup Jnawali¹, Michelle Yang¹

¹University of Massachusetts Memorial Health Care, UMass Chan Medical School, Worcester, MA 01605, USA.

Case Reports in Pathology

|July 6, 2023

Summary

Pleomorphic liposarcoma (PLS) is a rare gastrointestinal (GI) tumor. This case highlights diagnostic challenges, emphasizing histomorphology and lipoblast identification for accurate diagnosis of this high-grade malignancy.

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Area of Science:

Oncology
Gastroenterology
Pathology

Background:

Pleomorphic liposarcoma (PLS) is a rare soft tissue sarcoma.
Gastrointestinal (GI) tract involvement by PLS is exceptionally uncommon.
Diagnostic challenges exist due to rarity and lack of specific biomarkers.

Observation:

A 71-year-old female presented with small bowel obstruction.
A 7.8 cm transmural jejunal mass was resected.
Histology revealed a high-grade pleomorphic liposarcoma with lipoblasts, multinucleated giant cells, and high mitotic activity (80/10 HPFs).

Findings:

Immunohistochemistry was negative for common sarcoma and carcinoma markers.
P53 was diffusely positive, suggesting a mutant phenotype.
FISH assays excluded MDM2 amplification and DDIT3 rearrangement.
Morphologic features, including lipoblasts, confirmed the diagnosis of high-grade PLS.

Implications:

Accurate diagnosis of GI PLS relies heavily on histomorphology and identifying lipoblasts.
This case underscores the importance of considering rare diagnoses in the GI tract.
Further research may elucidate specific biomarkers for improved diagnosis and targeted therapy.