DISCOVERIES REPORTS (ISSN 2393249X), 2022, volume 3
ORIGINAL ARTICLE - CASE REPORT
Nishith N, Kadali K, Chowdhury Z, Shukla V. Dedifferentiated Liposarcoma of the Nasopharynx: A Case Report of a Rare Enigmatic Entity. Discoveries Reports 2022; 5(3): e36. DOI: 10.15190/drep.2022.10
Submitted: Nov 29, 2022; Revised: Dec 26, 2022; Accepted: Dec 30, 2022; Published: Dec 31, 2022
Dedifferentiated Liposarcoma of the Nasopharynx - A Case Report of a Rare Enigmatic Entity
1 Department of Oncopathology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital, Varanasi, India
2 Department of Nuclear Medicine and Molecular Imaging, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital, Varanasi, India
*Correspondence to: Dr. Nilay Nishith, Department of Oncopathology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital, Varanasi, India. Email: email@example.com
Liposarcoma is the second most common soft tissue sarcoma and is usually encountered in the retroperitoneum and lower extremities. Nasopharyngeal liposarcoma is exceptionally rare, with only four cases being reported to this date. Additionally, diagnosis of the dedifferentiated subtype of liposarcoma becomes particularly challenging on biopsy samples obtained from non-retroperitoneal sites, as it exhibits a wide morphological spectrum, less commonly shows an absence of a component of well-differentiated liposarcoma, and at times displays low-grade dedifferentiation. We report a case of nasopharyngeal low-grade dedifferentiated liposarcoma in a 36-year-old male, the diagnosis of which was limited by all the above-mentioned factors. However, a diligent search for lipoblast-like cells and the use of appropriate immunohistochemical markers lead to a conclusive diagnosis. We have also commented on the differential diagnoses that could compound the diagnostic dilemma and have attempted to probe into the site-specific prognostic implication of this rare malignancy. Accurate identification of DDL is foremost owing to the differences in management from its close mimickers and may confer a good prognosis, especially when it occurs in nasopharynx.
1. Chakraborty S, Kassel EE, Yu E. Nasopharyngeal liposarcoma MRI imaging features and a review of the literature. Br J Radiol. 2007 Jul;80(955):e145-6. doi: 10.1259/bar/49643955.
2. Allon I, Vered M, Dayan D. Liposarcoma of the tongue: clinico-pathologic correlations of a possible underdiagnosed entity. Oral Oncol. 2005 Aug;41(7):657-65. doi: 10.1016/j.oraloncology.2005.01.006.
3. Nageris B, Feinmesser M, Brama I, Feinmesser R. Liposarcoma of the nasopharynx: a case report. Ear Nose Throat J. 1991 Aug;70(8):520-2.
4. Knowles CH, Huggill PH. Liposarcoma: with report of a case in a child. J Pathol Bacteriol. 1954 Jul;68(1):235-45. doi: 10.1002/path.1700680129.
5. Papacharalampous GX, Kikidis D, Vasileiou A, Bousiotou A, Chrysovergis A. Liposarcoma of the nasopharynx: diagnosis and management of a rare diagnostic entity. Case Rep Med. 2012:314697. doi: 10.1155/2012/314697.
6. Chung L, Lau SK, Jiang Z, Loera S, Bedel V, Ji J, et al. Overlapping features between dedifferentiated liposarcoma and undifferentiated high-grade pleomorphic sarcoma. Am J Surg Pathol. 2009 Nov;33(11):1594-600. doi: 10.1097/PAS.0b013e3181accb01.
7. Thway K. Well-differentiated liposarcoma and dedifferentiated liposarcoma: An updated review. Semin Diagn Pathol. 2019 Mar;36(2):112-121. doi: 10.1053/j.semdp.2019.02.006.
8. Dei Tos AP, Marino-Enriquez A, Pedeutour F. Dedifferentiated liposarcoma. In: WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours, Fifth ed. Lyon (France): International Agency for Research on Cancer; 2020:39-41.
9. Thway K, Flora R, Shah C, Olmos D, Fisher C. Diagnostic utility of p16, CDK4, and MDM2 as an immunohistochemical panel in distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors. Am J Surg Pathol. 2012 Mar;36(3):462-9. doi: 10.1097/PAS.0b013e3182417330.
10. Nishio J, Nakayama S, Nabeshima K, Yamamoto T. Biology and Management of Dedifferentiated Liposarcoma: State of the Art and Perspectives. J Clin Med. 2021 Jul 22;10(15):3230. doi: 10.3390/jcm10153230. 11. Henricks WH, Chu YC, Goldblum JR, Weiss SW. Dedifferentiated liposarcoma: a clinicopathological analysis of 155 cases with a proposal for an expanded definition of dedifferentiation. Am J Surg Pathol. 1997 Mar;21(3):271-81. doi: 10.1097/00000478-199703000-00002.
12. Davis EC, Ballo MT, Luna MA, Patel SR, Roberts DB, Nong X, Sturgis EM. Liposarcoma of the head and neck: The University of Texas M. D. Anderson Cancer Center experience. Head Neck. 2009 Jan;31(1):28-36. doi: 10.1002/hed.20923.