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Retroperitoneal liposarcoma with colonic involvement: a case report.
[well-differentiated liposarcoma]
A
72
-
year
-old
male
visited
a
local
hospital
on
presentation
of
melena
.
Colonoscopy
revealed
a
protruded
lesion
in
the
ascending
colon
,
and
computed
tomography
revealed
a
20
cm
retroperitoneal
tumor
.
Biopsy
failed
to
provide
a
definitive
diagnosis
of
the
colonic
lesion
.
He
was
diagnosed
as
having
a
retroperitoneal
liposarcoma
and
an
ascending
colon
tumor
using
computed
tomography
,
and
referred
to
our
hospital
.
Biopsy
of
the
ascending
colon
lesion
showed
spindle
cells
with
fibrosis
.
On
immunohistochemical
staining
,
tumor
cells
were
positive
for
cyclin-dependent
kinase
4
and
murine
double
minute
2
,
and
the
lesion
was
diagnosed
as
a
well-differentiated
or
dedifferentiated
liposarcoma
.
The
retroperitoneal
liposarcoma
,
which
had
infiltrated
the
ascending
colon
,
was
resected
along
with
the
right
colon
and
the
right
kidney
.
Macroscopically
,
the
tumor
had
infiltrated
the
ascending
colon
,
forming
a
multinodular
solid
mass
in
the
lumen
and
the
right
kidney
.
Microscopic
finding
of
the
main
tumor
revealed
a
well-differentiated
liposarcoma
,
and
that
of
the
colonic
lesion
revealed
a
dedifferentiated
liposarcoma
with
nuclei
of
different
sizes
and
shapes
and
increased
spindle
cell
morphology
.
The
right
kidney
and
ureter
were
surrounded
by
tumor
cells
but
were
not
infiltrated
,
and
there
was
no
lymph
node
involvement
.
The
diagnosis
of
retroperitoneal
liposarcoma
is
often
difficult
because
symptoms
appear
only
after
the
tumor
becomes
very
large
.
Some
retroperitoneal
liposarcomas
are
found
on
computed
tomography
by
chance
.
The
clinical
course
of
this
case
was
very
rare
because
of
the
presentation
of
melena
as
the
first
symptom
and
the
detection
of
an
invasive
mass
in
the
ascending
colon
using
colonoscopy
.
Diseases
Validation
Diseases presenting
"increased spindle cell morphology. the right kidney"
symptom
dedifferentiated liposarcoma
well-differentiated liposarcoma
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