Primary liposarcoma of the thoracic spine: case report

Lipossarcoma primário ósseo da coluna lombar: relato de caso

“…Their presentation is variable and insidious, before signs of spinal cord compression are detected, i.e. the point at which the diagnosis becomes evident (1) , as in the present case.…”

“…Desmin is generally absent and the membrane antigen or CD34 is negative. The morphological characteristics and positivity for vimentin eliminate the hypothesis of blood diseases such as "signet ring" lymphoma or clear-cell myeloma (1,13) . Radiographically, the lesions are destructive, osteolytic and poorly defined, and they are observed to expand and destroy the cortex.…”

“…It is formed by areas of normal, multivacuolated or even pleomorphic lipoblasts, with large quantities of mitoses. Lesions with low degrees of differentiation are highly vascular (1,10,11) . The difficulty in diagnosing pleomorphic liposarcoma derives from its varied histological appearance.…”

“…Lipoblasts are not histological findings from this entity, and thus, this diagnosis was rejected in the present case. Immunohistochemical or ultrastructural analysis needs to be performed in order to establish the diagnosis (1) . Although pleomorphic liposarcoma has a nonspecific immunohistochemical profile, special stains may be necessary in order to identify the presence of intracellular fat, rule out other substances such as mucin or glycogen and rule out other diagnoses.…”

“…Pleomorphic liposarcoma is a high-grade tumor with highest prevalence between the ages of 60 and 70 years, and it affects both sexes equally. The commonest site for this tumor is the thigh, but other anatomical sites such as the lungs, heart, orbit, retroperitoneum, epidural space and bones (1) . The first reports on primary liposarcoma of bone were made by Ewing, Stewart and Barnard in the 1930s, and Ewing included it in his classification of bone tumors in 1939 (2)(3)(4) .…”