A case of perirenal extra-adrenal myelolipoma mimicking liposarcoma

Shimoda, H.; Kijima, Toshiki; Takada‐Owada, Atsuko; Ishida, Kazuyuki; Kamai, Takao

doi:10.1016/j.eucr.2023.102523

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Other lesions that can mimic well‐differentiated or de‐differentiated liposarcoma in this anatomical location include perinephric myxoid pseudotumor of fat, 21,22 extra‐adrenal myelolipoma, 23 myolipoma, 24 hibernoma, 25 pheochromocytoma, 26 pseudosarcomatous fibroblastic/myofibroblastic proliferation 27 and malignant solitary fibrous tumour 28 . Solitary fibrous tumour is particularly important to highlight, as up to 14% of de‐differentiated liposarcomas can have signal transducer and activator of transcription 6 (STAT6) expression by IHC 29,30 .…”

Section: Discussionmentioning

confidence: 99%

Diagnosing liposarcoma on (peri)‐renal mass biopsy: A clinicopathological study of 30 cases

Potterveld,

Mubeen,

Anderson

et al. 2024

Histopathology

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AimsClassification of renal neoplasms on small tissue biopsies is in increasing demand, and maintaining broad differential diagnostic considerations in this setting is necessary. When evaluating a renal or perirenal tumour biopsy with sarcomatoid morphology, together with sarcomatoid renal cell carcinoma and sarcomatoid urothelial carcinoma as top diagnostic considerations, it is vital to additionally consider the possibility of well‐differentiated and de‐differentiated liposarcoma.Methods and resultsThis study reports a series of 30 biopsy samples from sites in or around the kidney collected from four institutions in which the correct diagnosis was either well‐differentiated or de‐differentiated liposarcoma. The majority (26 of 30, 87%) of lesions were accurately diagnosed on biopsy sampling, all of which incorporated testing for MDM2 by immunohistochemistry (IHC), fluorescence in‐situ hybridisation (FISH) or a combination of the two as part of the diagnostic work‐up. Tumour expression of MDM2 by IHC without confirmatory FISH analysis was sometimes (30%) sufficient to reach a diagnosis, but demonstration of MDM2 amplification by FISH was ascertained in the majority (57%) of biopsy samples. A diagnosis of de‐differentiated liposarcoma was not definitively established until resection in four (13%) patients, as no MDM2 testing was performed on the corresponding pre‐operative biopsies.ConclusionsWhen a retroperitoneal tumour is not clinically suspected, histological consideration of a liposarcoma diagnosis may be overlooked. Implementation of ancillary immunohistochemical and cytogenetic testing can ultimately lead to a definitive diagnosis in this potentially misleading anatomical location.

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Section: Discussionmentioning

confidence: 99%

Diagnosing liposarcoma on (peri)‐renal mass biopsy: A clinicopathological study of 30 cases

Potterveld,

Mubeen,

Anderson

et al. 2024

Histopathology

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Rare huge bilateral adrenal myelolipoma confused with retroperitoneal liposarcoma

Ito,

Yamashita,

Sakura

et al. 2024

IJU Case Reports

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IntroductionAdrenal myelolipomas are uncommon benign adrenal tumors, which mostly occur unilaterally. We describe a rare case of giant bilateral adrenal myelolipoma mistaken for retroperitoneal liposarcoma.Case presentationA 49‐year‐old man developed fever, left flank pain, and a large mass in his left abdomen. Plain computed tomography showed a 23‐cm mass with fat‐containing components in the retroperitoneal cavity, suggestive of retroperitoneal liposarcoma. A similar 9‐cm mass was observed in the right adrenal gland, suggesting adrenal metastasis. With a clinical diagnosis of retroperitoneal liposarcoma, we administered preoperative radiation therapy and performed a bilateral tumor resection. On postoperative day 9, a surgical site infection occurred, necessitating incisional drainage and the administration of intravenous antibiotics. The histopathological diagnosis was bilateral myelolipoma of the adrenal glands.ConclusionIn cases of bilateral retroperitoneal tumors with a large fat component, adrenal myelolipoma should be considered in the differential diagnosis to avoid overtreatment.

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