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Computed Tomography Manifestations of Histologic Subtypes of Retroperitoneal Liposarcoma

  • Lu, Jing (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Qin, Qin (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Zhan, Liang-Liang (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Yang, Xi (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Xu, Qing (Department of Radiology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Yu, Jing (Department of Radiology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Dou, Li-Na (Department of Radiology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Zhang, Hao (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Yang, Yan (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Chen, Xiao-Chen (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Yang, Yue-Hua (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University) ;
  • Cheng, Hong-Yan (Department of Synthetic Internal Medicine, the First Affiliated Hospital of Nanjing Medical University) ;
  • Sun, Xin-Chen (Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University)
  • Published : 2014.08.15

Abstract

Objective: Liposarcoma (LPS) is the most common soft tissue sarcoma and accounts for approximately 20% of all mesenchymal malignancies, often occurring in deep soft tissue of retroperitoneal space. Accurate preoperative diagnosis is therefore necessary. We explored whether computed tomography (CT) could be used to differentiate between the various types of retroperitoneal liposarcoma (RPLS). Method: Forty-seven cases of RPLS, diagnosed surgically and histologically, were analyzed retrospectively. CT features were correlated with postoperative pathological appearance. Results: The study radiologist identified 29, 11, 2, 2 and 3 RPLS as atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL), dedifferentiated liposarcoma (DDL), myxoid/round cell liposarcoma (ML/RCL), pleomorphic liposarcoma (PL) and mixed-type liposarcoma. Analysis of CT scans revealed the following typical findings of the different subtypes of RPLS: ALT/WDL was mainly visible as a well-delineated fatty hypodense tumor with uniform density and integrity margin; DDL was marked by the combination of focal nodular density and hypervascularity. ML/RCL, PL and mixed liposarcoma showed malignant biological behaviour and CT findings need further studies. Conclusions: CT scanning can reveal important details including internal components, margins and surrounding tissues. Based on CT findings, tumor type can be roughly evaluated and biopsy location and therapeutic scheme guided.

Keywords

References

  1. Barile A, Zugaro L, Catalucci A, et al (2002). Soft tissue liposarcoma: histological subtypes, MRI and CT findings. Radiol Med, 104, 140-9.
  2. Bhurgri Y, Bhurgri H, Pervez S, et al (2008). Epidemiology of soft tissue sarcomas in Karachi South, Pakistan (1995-7). Asian Pac J Cancer Prev, 9, 709-14.
  3. Cao J, Huang XE, Liu J, et al (2013). Comparison of efficacy and toxicity of first line chemotherapy with or without epirubicin for patients with advanced stage soft tissue sarcoma. Asian Pac J Cancer Prev, 14, 7171-7. https://doi.org/10.7314/APJCP.2013.14.12.7171
  4. Clark MA, Fisher C, Judson I, Thomas JM (2005). Soft-tissue sarcomas in adults. N Engl J Med, 353, 701-11. https://doi.org/10.1056/NEJMra041866
  5. Coli P, Sciandra PC, Marzano T (2000). Myxoid liposarcoma of the retroperitoneum. Presentation of a clinical case. Minerva Chir, 55, 537-40.
  6. Cui Q, Li D, Zhang J, et al (2012). The significance of preoperative chemotherapy in evaluation of recurrent soft tissue liposarcoma necrosis. Pathol Oncol Res, 18, 629-33. https://doi.org/10.1007/s12253-011-9487-3
  7. Dei Tos AP (2000). Liposarcoma: new entities and evolving concepts. Ann Diagn Pathol, 4, 252-66. https://doi.org/10.1053/adpa.2000.8133
  8. Dugandzija T, Mikov MM, Solajic N, et al (2014). Increasing frequency of soft tissue sarcomas in Vojvodina - comparison with the literature. Asian Pac J Cancer Prev, 15, 1011-4. https://doi.org/10.7314/APJCP.2014.15.2.1011
  9. Duman BB, Gunaldi M, Ercolak V, et al (2012). Retrospective analysis of 498 primary soft tissue sarcomas in a single Turkish centre. Asian Pac J Cancer Prev, 13, 4125-8. https://doi.org/10.7314/APJCP.2012.13.8.4125
  10. El-Bared N, Taussky D, Mehiri S, et al (2014). Preoperative Intensity Modulated Radiation Therapy for Retroperitoneal Sarcoma. Technol Cancer Res Treat, 13, 211-6.
  11. ESMO/European Sarcoma Network Working Group (2012). Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 23 Suppl.7, vii92-9. https://doi.org/10.1093/annonc/mds310
  12. Fernandez-Pello S, Rivas M, Rodriguez Villamil L, et al (2012). Giant retroperitoneal sarcoma: case report. Arch Esp Urol, 65, 492-5.
  13. Fletcher CDM, Unni KK, Mertens F (2002). Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press.
  14. Gronchi A, De Paoli A, Dani C, et al (2014). Preoperative chemoradiation therapy for localized retroperitoneal sarcoma: A phase I-II study from the Italian Sarcoma Group. Eur J Cancer, 50, 784-92. https://doi.org/10.1016/j.ejca.2013.11.021
  15. Hong SH, Kim KA, Woo OH, et al (2010). Dedifferentiated liposarcoma of retroperitoneum: spectrum of imaging findings in 15 patients. Clin Imaging, 34, 203-10. https://doi.org/10.1016/j.clinimag.2009.12.025
  16. Jeanmonod P, Sperling J, Seidel R, et al (2011). Torquated giant appendix epiploica mimicking intraperitoneal liposarcoma: report of a case. Int Surg, 96, 117-9. https://doi.org/10.9738/1394.1
  17. Kaya AO, Buyukberber S, Ozkan M, et al (2012). Efficacy and toxicity of gemcitabine plus docetaxel combination as a second line therapy for patients with advanced stage soft tissue sarcoma. Asian Pac J Cancer Prev, 13, 463-7. https://doi.org/10.7314/APJCP.2012.13.2.463
  18. Kransdorf MJ, Bancroft LW, Peterson JJ, et al (2002). Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology, 224, 99-104. https://doi.org/10.1148/radiol.2241011113
  19. Murphey MD, Arcara LK, Fanburg-Smith J (2005). From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics, 25, 1371-95. https://doi.org/10.1148/rg.255055106
  20. Lahat G, Madewell JE, Anaya DA, et al (2009). Computed tomography scan-driven selection of treatment for retroperitoneal liposarcoma histologic subtypes. Cancer, 115, 1081-90. https://doi.org/10.1002/cncr.24045
  21. Leao P, Vilaca S, Oliveira M, Falcao J (2012). Giant recurrent retroperitoneal liposarcoma initially presenting as inguinal hernia: Review of literature. Int J Surg Case Rep, 3, 103-6. https://doi.org/10.1016/j.ijscr.2011.03.009
  22. Linehan DC, Lewis JJ, Leung D, Brennan MF (2000). Influence of biologic factors and anatomic site in completely resected liposarcoma. J Clin Oncol, 18, 1637-43.
  23. Ngan R, Wang E, Porter D, et al (2013). Soft-tissue sarcomas in the Asia-Pacific region: a systematic review. Asian Pac J Cancer Prev, 14, 6821-32. https://doi.org/10.7314/APJCP.2013.14.11.6821
  24. Pervaiz N, Colterjohn N, Farrokhyar F, et al (2008). A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer, 113, 573-81. https://doi.org/10.1002/cncr.23592
  25. Pohnan R, Ryska M, Kucera M, Chmatal P (2008). Rare cases of extensive retroperitoneal liposarcomas. Rozhl Chir, 87 (7), 364-6.
  26. Selmani R, Begovic G, Janevski V, et al (2011). Giant retroperitoneal liposarcoma: a case report. Prilozi, 32, 323-32.
  27. Song T, Shen J, Liang BL, et al (2007). Retroperitoneal liposarcoma: MR characteristics and pathological correlative analysis. Abdom Imaging, 32, 668-74. https://doi.org/10.1007/s00261-007-9220-6
  28. Storm FK, Mahvi DM (1991). Diagnosis and management of retroperitoneal soft-tissue sarcoma. Ann Surg, 214 (1), 2-10.
  29. Tierney JF (1997). Adjuvant chemotherapy for localised respectable soft-tissue sarcoma of adults: meta-analysis of individual data. Lancet, 350, 1647-54. https://doi.org/10.1016/S0140-6736(97)08165-8
  30. Woll PJ, Reichardt P, Le Cesne A, et al (2012). EORTC Soft Tissue and Bone Sarcoma Group and the NCIC Clinical Trials Group Sarcoma Disease Site Committee. Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue sarcoma (EORTC 62931): a multicentre randomised controlled trial. Lancet Oncol, 13, 1045-54. https://doi.org/10.1016/S1470-2045(12)70346-7
  31. Xiao WB, Wang ZM, Xu SL (2005). Correlation between pathology and image characteristics of retroperitoneal liposarcoma. Zhonghua Zhong Liu Za Zhi, 27, 235-7.
  32. Yetisyigit T, Arpaci E, Seber ES, et al (2013). Salvage treatment experience in advanced synovial sarcoma: a multicenter retrospective analysis of the Anatolian Society of Medical Oncology. Asian Pac J Cancer Prev, 14, 5185-8. https://doi.org/10.7314/APJCP.2013.14.9.5185
  33. Zhang LP, Liao XY, Xu YM, et al (2013). Efficacy and Safety of endostar combined with chemotherapy in patients with advanced soft tissue sarcomas. Asian Pac J Cancer Prev, 14, 4255-9. https://doi.org/10.7314/APJCP.2013.14.7.4255

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