Primary dedifferentiated liposarcoma of the femur presenting with malignant fibrous histiocytoma: A case report and review of the literature

Abstract

In the current report a case of a 26-year-old male with a primary dedifferentiated liposarcoma of the femur accompanied by malignant fibrous histiocytoma is presented. The patient complained of a dull intermittent pain, for three months, along the anterolateral aspect of the right knee and was referred to Southwest Hospital (Chongqing, China) in May 2013. All of the radiographic findings, including radiography, magnetic resonance image and emission computed tomography (CT) supported the diagnosis of a primary malignant bone tumor. CT-guided biopsy results demonstrated blood clots and a small quantity of heterogeneous cells. Thus, a limb-salvage procedure, involving a wide resection and total knee endoprosthesis replacement, was performed in May 2012. The final pathological diagnosis was of a primary dedifferentiated liposarcoma of the femur and the dedifferentiated tissue was identified as malignant fibrous histiocytoma. On review of the literature, it was identified that primary intraosseous liposarcoma are a rare and malignant tumor of the skeletal system, with only a small number of cases reported in the English literature since 1980. To the best of our knowledge, a case of dedifferentiated liposarcoma has not previously been reported.

Pleomorphic liposarcoma of bone: a rare primary malignant bone tumour

“…Although liposarcoma is a relatively common malignant soft tissue tumour, it has only rarely been reported in bone (Table 1 ). In most of these reports, the tumour was simply described as a primary bone sarcoma containing numerous vacuolated pleomorphic tumour cells with the tumour considered to represent a liposarcoma mainly on cytomorphological grounds [ 2 – 4 , 12 – 29 ]. Several of these reports have been questioned on the basis of histological interpretation and uncertainty as to whether the lesion was entirely located within bone.…”

“…However, other high-grade primary malignant tumours containing liposarcomatous elements have been described in bone. These include a liposarcoma containing osteosarcomatous foci [ 25 ], a mesenchymoma of bone showing liposarcomatous features [ 36 ] and a primary dedifferentiated liposarcoma of the femur that presented as a malignant fibrous histiocytoma [ 29 ]. Downey et al [ 25 ] specified that several criteria must be met for the acceptance of a diagnosis of a primary intraosseous liposarcoma of bone.…”

Genetic characteristics and molecular diagnostics of bone tumors

“…Liposarcoma [134][135][136] Supernumerary ring and giant chromosome markers with amplification of 12q13-15, including MDM2 and CDK4 Pleomorphic subtype: complex genetics with various CNV…”