PMC8675617_01
(A) Contrast-enhanced computed tomography (CECT) shows pleural-based heterogenous hypodense mass. (B) Baseline positron emission tomography-computed tomography shows local disease. (C) CECT shows large abdominopelvic mass. (D) CECT shows presacral deposit.
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Baseline contrast-enhanced computed tomography (CECT) of the chest revealed a well-defined 20.8 x 13.6 x 13-cm pleural-based heterogeneous hypodense mass (10-12 Hounsfield units) along the right lateral chest wall, medially extending into the mediastinum and compressing the heart with collapse of the right lung (Figure 1A). Baseline positron emission tomography-CT (PET-CT) for staging revealed localized disease (Figure 1B), so the likelihood of metastasis from the common primary sites of liposarcoma (eg, extremities, retroperitoneum) was excluded. CECT of the abdomen revealed a 30.5 x 25-cm abdominopelvic mass and 2 soft-tissue deposits in the subhepatic space and rectovesical pouch with no residual disease in the chest (Figure 1C). CECT showed multiple soft tissue deposits in the right lumbar region, right hemipelvis, and presacral region with no evidence of pulmonary disease (Figure 1D).
(A) Pleomorphic liposarcoma tumor deposit shows admixture of pleomorphic lipoblasts with epithelioid cells (hematoxylin and eosin, x100). (B) Pleomorphic liposarcoma tumor deposit shows multivacuolated lipoblasts with indented pleomorphic nuclei (hematoxylin and eosin, x200). (C) Pleomorphic liposarcoma cells are positive for S-100 (immunohistochemistry, x200). (D) Pleomorphic liposarcoma cells show diffuse p53 expression (immunohistochemistry, x200).
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The histopathology of both the thoracic and abdominal tumors showed features of PLS (Figures 2A and 2B) with brisk mitosis (18/10 high power fields) and necrosis (<50%). P and nuclear expression of p53 in 80% of cells but negativity for MDM2 (Figures 2C and 2D). Postoperative CECT showed peritoneal and omental deposits.