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Pleomorphic liposarcoma of the uterine corpus with focal smooth muscle differentiation.
[pleomorphic liposarcoma]
We
describe
a
rare
case
of
a
pleomorphic
liposarcoma
(
>
95
%
)
of
the
uterine
corpus
with
focal
leiomyosarcomatous
(
<
5
%
)
differentiation
,
and
review
the
literature
on
10
purely
mesenchymal
liposarcomatous
tumors
of
the
uterine
corpus
reported
earlier
.
The
patients
,
including
this
case
,
ranged
in
age
from
45
to
78
years
(
mean
and
median
59
y
)
and
frequently
presented
with
abnormal
uterine
bleeding
and
/
or
abdominal
pain
.
The
tumors
were
typically
large
(
average
tumor
size
15
.
79
cm
,
range
:
7
to
28
cm
)
,
and
displayed
a
cut
surface
with
hemorrhage
and
gross
degeneration
.
Most
tumors
were
confined
to
the
uterus
after
initial
evaluation
.
Follow
up
was
available
in
10
(
91
%
)
of
the
11
patients
.
Five
(
50
%
)
of
the
10
patients
showed
no
evidence
of
tumor
recurrence
or
metastases
at
an
average
follow-up
of
30
.
4
months
.
The
remaining
5
patients
experienced
recurrence
within
the
first
year
of
their
extirpative
operations
.
However
,
2
(
40
%
)
of
the
5
patients
who
showed
no
recurrence
had
limited
follow-up
(
2
and
6
mo
)
.
After
excluding
cases
without
follow-up
and
nonrecurring
cases
with
less
than
1
-
year
follow-up
,
the
overall
rate
of
recurrence
or
metastases
was
62
.
5
%
(
5
of
8
)
.
Eight
(
72
.
7
%
)
of
the
11
reported
cases
were
associated
with
smooth
muscle
neoplasia
,
including
2
cases
designated
as
"
mesenchymoma
"
with
liposarcomatous
,
leiomyosarcomatous
,
and
osteosarcomatous
elements
;
1
case
of
a
myxoid
liposarcoma
arising
from
a
leiomyoma
;
and
5
cases
of
tumors
with
varying
amounts
of
leiomyosarcomatous
and
liposarcomatous
components
.
On
the
basis
of
this
review
,
we
postulate
that
a
significant
subset
of
liposarcomatous
tumors
of
the
uterus
may
actually
represent
an
unusual
form
of
divergent
differentiation
of
leiomyosarcomas
.
This
may
have
adjuvant
management
implications
for
patients
with
these
rare
tumors
.
Diseases
Validation
Diseases presenting
"tumor recurrence"
symptom
carcinoma of the gallbladder
cholangiocarcinoma
cutaneous mastocytosis
dedifferentiated liposarcoma
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
liposarcoma
pleomorphic liposarcoma
thoracic outlet syndrome
von hippel-lindau disease
well-differentiated liposarcoma
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