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Liposarcomas with mixed well-differentiated and pleomorphic features: a clinicopathologic study of 12 cases.
[pleomorphic liposarcoma]
Pleomorphic
liposarcoma
(
PL
)
is
an
undifferentiated
pleomorphic
sarcoma
containing
pleomorphic
lipoblasts
.
PL
almost
always
arises
de
novo
without
an
associated
low
-grade
precursor
lesion
[
eg
,
well-differentiated
liposarcoma
(
WDL
)
]
.
We
have
,
however
,
observed
rare
cases
of
PL
,
which
arose
in
association
with
WDL
and
have
studied
these
cases
to
define
their
clinicopathologic
features
and
their
nosologic
relationship
to
other
forms
of
liposarcoma
.
Cases
were
retrieved
from
our
consultation
archives
and
from
review
of
cases
treated
surgically
at
Mayo
Clinic
.
Selected
tumors
were
tested
for
MDM
2
/
CPM
amplification
by
fluorescence
in
situ
hybridization
when
tumor
blocks
were
available
.
Twelve
tumors
were
identified
,
occurring
in
7
men
and
5
women
(
mean
age
59
y
,
range
:
35
-
84
y
)
.
Sites
of
origin
included
the
retroperitoneum
(
7
)
,
scrotum
(
2
)
,
buttock
(
2
)
,
and
abdominal
cavity
(
1
)
.
Tumors
consisted
predominately
of
typical
WDL
,
with
an
"
abrupt
"
transition
to
pleomorphic
spindle
cell
sarcoma
containing
pleomorphic
lipoblasts
.
MDM
2
/
CPM
amplification
was
present
in
10
of
11
(
91
%
)
cases
,
all
of
which
consisted
chiefly
of
PL
in
the
studied
blocks
.
Follow-up
information
was
available
for
7
of
7
patients
with
a
postresection
interval
of
>
12
months
(
range
:
14
-
165
mo
,
mean
44
mo
)
.
Four
of
these
7
patients
are
currently
alive
without
disease
(
mean
follow-up
duration
,
38
mo
)
.
Of
the
remaining
3
patients
,
1
died
of
progressive
disease
29
months
after
diagnosis
,
1
suffered
lung
metastases
and
local
recurrence
60
and
84
months
after
diagnosis
,
respectively
,
and
was
alive
with
unresectable
disease
165
months
after
diagnosis
,
and
1
died
14
months
after
diagnosis
,
of
unrelated
causes
.
The
5
patients
with
a
postoperative
follow-up
duration
of
<
12
months
are
without
evidence
of
disease
.
We
conclude
that
PL
arising
in
WDL
is
a
rare
phenomenon
.
The
presence
of
MDM
2
/
CPM
amplification
in
the
PL
component
of
mixed
WDL
/
PL
suggests
that
a
subset
of
PL
may
arise
through
tumor
progression
of
WDL
or
may
represent
a
"
transitional
"
or
partially
differentiated
step
toward
classic
DL
.
Diseases
Validation
Diseases presenting
"abdominal cavity"
symptom
child syndrome
dedifferentiated liposarcoma
erdheim-chester disease
pleomorphic liposarcoma
well-differentiated liposarcoma
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