Distant metastasis in retroperitoneal dedifferentiated liposarcoma is rare and rapidly fatal: A clinicopathological study with emphasis on the low-grade myxofibrosarcoma-like pattern as an early sign of dedifferentiation Journal Article

  

Authors:	Huang, H. Y.; Brennan, M. F.; Singer, S.; Antonescu, C. R.
Article Title:	Distant metastasis in retroperitoneal dedifferentiated liposarcoma is rare and rapidly fatal: A clinicopathological study with emphasis on the low-grade myxofibrosarcoma-like pattern as an early sign of dedifferentiation
Abstract:	The metastatic incidence of retroperitoneal dedifferentiated liposarcoma is comparatively lower than other pleomorphic sarcomas, varying widely from 1 to 18%. Low-grade dedifferentiation resembling low-grade fibrosarcoma has been recently accepted as part of the morphologic spectrum of dedifferentiated liposarcoma and was reported to have similar metastatic and survival rates to its high-grade counterpart. We sought to determine the metastatic incidence of retroperitoneal dedifferentiated liposarcoma, the clinicopathological features related to metastasis, and their postmetastatic behavior. Of all 354 retroperitoneal liposarcoma cases diagnosed at Memorial Sloan-Kettering Cancer Center during 1982-2003, we identified seven patients developing distant metastases, occurring in four females and three males, ranging from 35 to 73 years in age at presentation. They were all de novo dedifferentiated, while none of the well-differentiated liposarcoma or secondary dedifferentiated liposarcoma developed distant metastasis. Primary tumor sizes varied from 7.5 to 25 cm. All seven patients developing metastases contained ≥50% dedifferentiated elements in the primary tumor, with a predominant morphology resembling myxofibrosarcoma in five cases. The metastatic sites included the lung in four patients, somatic soft tissue in two, and liver in one. The median metastasis-free survival was 48 months, with only two patients experiencing local recurrences before developing metastasis. Six patients died of disease at median follow-up of 53 months after diagnosis and only 5 months after their first metastases. In conclusion, retroperitoneal dedifferentiated liposarcoma have a low metastatic rate, which is strongly related to de novo dedifferentiated histology that usually constitutes a prominent component of the primary tumor. Irrespective of the grade dedifferentiated liposarcoma with myxofibrosarcoma-like features should be closely monitored. Once metastases occur, they tend to follow a rapidly fatal course. © 2005 USCAP, Inc All rights reserved.
Keywords:	adult; cancer survival; clinical article; human tissue; aged; middle aged; cancer recurrence; follow up; follow-up studies; cancer incidence; cancer grading; metastasis; tumor volume; cell differentiation; histology; time factors; cancer center; liver metastasis; lung metastasis; fibrosarcoma; neoplasm metastasis; retroperitoneal neoplasms; liposarcoma; retroperitoneal cancer; muscle metastasis; fibromyxosarcoma; retroperitoneal; dedifferentiated liposarcoma; low-grade dedifferentiation; myxofibrosarcoma-like
Journal Title:	Modern Pathology
Volume:	18
Issue:	7
ISSN:	0893-3952
Publisher:	Nature Research
Date Published:	2005-07-01
Start Page:	976
End Page:	984
Language:	English
DOI:	10.1038/modpathol.3800381
PUBMED:	15832195
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-23044482896&partnerID=40&md5=c3a6fed27730bf2ef7e611465f20f8f8
Notes:	--- - "Cited By (since 1996): 21" - "Export Date: 24 October 2012" - "CODEN: MODPE" - "Source: Scopus"

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