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Paratesticular dedifferentiated liposarcoma with leiomyosarcomatous differentiation: a case report with a review of literature.
[well-differentiated liposarcoma]
Paratesticular
liposarcoma
is
a
rare
neoplasm
,
described
in
single
case
studies
or
components
of
larger
studies
,
as
histologically
well-differentiated
liposarcoma
(
WDL
)
and
dedifferentiated
liposarcoma
(
DL
)
.
However
,
leiomyosarcomatous
differentiation
is
an
extremely
rare
occurrence
in
WDL
and
DL
.
We
report
a
case
of
leiomyosarcomatous
differentiation
in
a
77
-
year
-old
man
.
The
patient
presented
with
a
painless
right
scrotal
mass
.
Magnetic
resonance
imaging
showed
a
large
mass
along
the
right
spermatic
cord
.
The
resected
mass
,
measuring
17
.
5
×
12
×
5
cm
,
was
composed
of
a
high
-grade
pleomorphic
undifferentiated
sarcomatous
component
with
necrosis
.
Atypical
smooth
muscle
differentiation
was
also
detected
.
Additional
tumor
sampling
revealed
the
presence
of
a
WDL
component
.
Immunohistochemical
analysis
of
the
pleomorphic
sarcomatous
component
showed
positive
staining
for
MDM
2
and
CDK
4
,
and
negative
staining
for
alpha
smooth
muscle
actin
(
αSMA
)
and
desmin
.
The
smooth
muscle
component
was
positive
for
αSMA
and
desmin
,
and
negative
for
MDM
2
and
CDK
4
.
Extension
from
primary
retroperitoneal
sarcoma
was
not
proved
.
We
diagnosed
of
DL
with
leiomyosarcomatous
differentiation
.
The
virtual
slide
(
s
)
for
this
article
can
be
found
here
:
http
:
/
/
www
.
diagnosticpathology
.
diagnomx
.
eu
/
vs
/
1484291498104021
.
Diseases
Validation
Diseases presenting
"painless right scrotal mass"
symptom
dedifferentiated liposarcoma
well-differentiated liposarcoma
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