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Well-differentiated and dedifferentiated liposarcomas with prominent myxoid stroma: analysis of 56 cases.
[dedifferentiated liposarcoma]
 
Occasional
cases
of
well-differentiated
and
dedifferentiated
liposarcoma
(
LPS
)
contain
myxoid
stroma
,
leading
to
confusion
with
other
sarcomas
.
The
aim
of
this
study
was
to
analyse
the
clinicopathological
and
genetic
features
of
well-differentiated
/
dedifferentiated
LPS
with
prominent
myxoid
stroma
.
 
Fifty
-
six
cases
of
LPS
(
22
well-differentiated
;
34
dedifferentiated
)
with
prominent
myxoid
stroma
were
evaluated
.
Most
arose
in
the
retroperitoneum
,
abdominal
cavity
,
or
spermatic
cord
.
The
mean
size
was
170
 
mm
.
Myxoid
LPS-like
plexiform
vessels
were
conspicuous
in
11
cases
of
well-differentiated
LPS
.
In
22
cases
of
dedifferentiated
LPS
,
myxofibrosarcoma
-like
curvilinear
vessels
were
prominent
.
In
other
cases
,
the
myxoid
component
had
variably
bland
or
pleomorphic
morphology
.
By
immunohistochemistry
,
staining
for
MDM
2
was
positive
in
95
%
of
cases
,
and
CDK
4
in
78
%
.
Cytogenetics
in
13
cases
showed
ring
and
giant
marker
chromosomes
.
Fluorescence
in
-situ
hybridization
showed
amplification
of
12
q
13
-
15
in
six
cases
evaluated
.
Of
30
patients
with
follow-up
,
all
but
one
had
local
recurrences
(
up
to
four
)
,
but
only
one
has
so
far
had
distant
metastases
.
 
Well-differentiated
/
dedifferentiated
LPS
with
prominent
myxoid
stroma
can
closely
resemble
other
sarcoma
types
,
especially
myxoid
LPS
and
myxofibrosarcoma
.
The
clinical
presentation
(
large
retroperitoneal
or
abdominal
tumour
)
is
a
clue
to
the
correct
diagnosis
;
the
degree
of
nuclear
atypia
helps
to
exclude
myxoid
LPS
.
Immunohistochemistry
for
MDM
2
and
CDK
4
and
genetic
analysis
can
be
useful
to
confirm
the
diagnosis
.
Diseases
Validation
Diseases presenting
"especially myxoid"
symptom
dedifferentiated liposarcoma
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