Electron Microscopy in the Diagnosis of Liposarcoma and Fibrosarcoma of the Larynx

Abstract

Electron microscopy (EM) was useful in establishing the final diagnosis in specific instances of liposarcoma and fibrosarcoma of the larynx. In the first case light microscopy revealed cells that met the histologic criteria of a low grade liposarcoma; EM revealed cells that displayed a varied ultrastructural differentiation; thus the tumor was classified as a mixed mesenchymal tumor rather than liposarcoma per se. In the second case, pathologic evaluation indicated a grade 2 fibrosarcoma. EM revealed malignant mesenchymal cells that closely recapitulated normal fibroblasts (no epithelial differentiation was present). This kind of information enables more accurate determination of the source of the primary lesion than results of light microcsopy alone.

Dedifferentiated liposarcoma of the oral floor: A case study and literature review of 50�cases of head and neck neoplasm

“…Therefore, we could not confirm whether the DDLSs involved the oral floor in these cases. As described in Table I , DDLS has been reported to develop at various sites in the H&N region ( 7 , 11 , 12 , 15 – 42 ). Among these, the most common site was the larynx (6 patients), followed by the cheek (5 patients), neck (3 patients), orbit (3 patients), pyriform sinus (3 patients), buccal area (2 patients), tongue (2 patients), parotid gland, pharyngeal space, posterior neck, paralaryngeal area, nose, maxillary gingiva, and oral floor (current case), i.e., anywhere in the H&N region ( Table I ).…”

“…The exclusion criteria were i) cases from non-English literature, ii) cases in which DDLS metastasis from non-H&N regions was apparent ( 12 , 13 ) and iii) a case in which it could not be determined whether the lesion was a DDLS or WDLS ( 14 ). We identified 50 cases [excluding the cases in Tirumani et al ( 12 ) study, where the number of cases was stated as ‘not applicable’ (NA)], which are listed in Table I ( 7 , 11 , 12 , 15 – 42 ). However, no patient had oral floor DDLS.…”

“…No patients underwent preoperative therapy, but 12 patients (including our case) underwent postoperative RT. No patient underwent postoperative chemotherapy, but one patient underwent therapy for the recurrence of the tumor ( 15 ). Given the sparse clinical details, the present literature review was unable to report any conclusions regarding treatment suggestions.…”

True carcinosarcoma of the larynx

“…Chondrosarcoma is by far the most common sarcoma of the larynx, accounting for 48 per cent of all cases (Barnes, 1985). However, one example of malignant mesenchymoma has been reported in the larynx (Tobey et al, 1979). This tumour was thought to be a liposarcoma on light microscopy, but ultrastructurally, it was composed of a variety cells which were also compatible with fibroblasts, skeletal and smooth muscle cells.…”

Dedifferentiated Liposarcoma of the Pyriform Sinus

“…Most of them are of the well-differentiated type. Only twice have mentions been made in the literature of cases of dedifferentiated liposarcomas in this location [3,4]. We present a new case of dedifferentiated liposarcoma in the laryngeal area and review the problems of differential diagnosis that this entity raises.…”