Variation in myxoid liposarcoma: Clinicopathological examination of four cases with detectable TLS-CHOP or EWS-CHOP fusion transcripts whose histopathological diagnosis was other than myxoid liposarcoma.

[well-differentiated liposarcoma]

Liposarcomas are separated into clinicopathological entities by a characteristic morphological spectrum and distinctive genetic changes . Myxoid liposarcoma (MLS ) represents one such entity with specific chromosomal translocations leading to the generation of fusion genes , the human translocation liposarcoma (TLS )-CCAAT /enhancer binding protein (C /EBP ) homologous protein (CHOP ) or the Ewing sarcoma (EWS )-CHOP . In the present study , four cases of liposarcoma with detection of TLS-CHOP or EWS-CHOP , whose postoperative diagnosis was other than MLS (one well-differentiated liposarcoma , two de -differentiated liposarcomas and one unclassified ) were examined for medical records , imaging data and histopathology . Clinical records demonstrated that three of the four cases were considerably difficult to diagnose definitively , and histopathological re -examination pointed out areas of myxomatous change as a minor component (<10 %). Their dominant components (>90 %) resembled pleomorphic sarcoma , pleomorphic malignant fibrous histiocytoma and monophasic synovial sarcoma . The current cases may represent an extreme variant of the morphological spectrum within MLS . In cases of difficulty in making definitive diagnosis of soft tissue sarcoma by standard histopathological examination and identification of myxoid stroma even as a minor component , analyzing TLS-CHOP and EWS-CHOP fusion genes may aid the diagnosis of unusual MLS .

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Diseases presenting "standard histopathological examination" symptom

well-differentiated liposarcoma

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