PMC7683141_01
Images of myxoid liposarcoma in the left thigh at initial visit. Plain radiograph in (a) anteroposterior and (b) lateral view, (c) PET, (d) T1-weighted, (e) T2-weighted, and (f) T1-weighted fat suppressed MRI.
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A plain radiograph indicated a slight calcification in the posterior middle part of her thigh (Figures 1(a) and 1(b)). Positron emission tomography (PET) revealed a partially moderate uptake inside the tumor (Figure 1(c)). MRI showed a huge, inhomogenous mass (18.7 x 11 x 7.8 cm) associated with a lipomatous lesion (Figures 1(d)-1(f)).
Tumor at the moment of revisiting and hip disarticulation for tumor excision. Tumor in (a) macroscopic image, (b) T1-weighted, and (c) T2-weighted MRI. (d) Plain radiograph after left hip disarticulation.
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Three years later, she revisited us since the tumor had progressively enlarged and skin breakdown had occurred (Figure 2(a)). The tumor had enlarged to 22 x 14 x 9 cm and invaded the neurovascular structures (Figures 2(b) and 2(c)). As a limb-salvage procedure seemed impossible, we performed hip disarticulation (Figure 2(d)).
Metastatic tumors in the lower right leg, abdominal space, and chest wall. (a) T1-weighted and (b) T2-weighted MRI showing metastatic tumor in the lower right leg. Metastasis in (c) abdominal space and (d) chest wall in PET.
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Two years postoperation, multiple metastases appeared in the lower right leg, left chest wall, abdominal subcutis, and intra-abdominal space (Figure 3).
Response to chemotherapy in metastatic myxoid liposarcoma. Computed tomography (a-c) before and (d-f) after 3 cycles of trabectedin showing progressive disease. Partial response was obtained 5 months after treatment with eribulin (g-i). The tumors were under control for another 10 months (j-l).
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Three cycles of trabectedin (dose: 1.2 mg/m2, 24 hours intravenously from a central venous catheter; no remarkable adverse effect including hematotoxicity was observed) were conducted, resulting in progressive disease (Figures 4(a)-4(f)). We subsequently switched the regimen to eribulin (dose: 1.4 mg/m2, intravenously), which evinced a partial response (Figures 4(g)-4(l)).