Rare Case of Primary Pulmonary Pleomorphic Liposarcoma Treated With Multimodal Therapy

Abstract

Background: Pleomorphic liposarcoma (PLS) is a very rare type of primary pulmonary sarcoma. Clinical data about these tumors are limited, and optimal treatment has not yet been defined. Case Report: A 32-year-old male presented with pain and heaviness over the right chest. Contrast-enhanced computed tomography (CECT) of the chest showed a heterogeneous hypodense pleural-based mass and a mediastinal mass. The patient was treated with chemoradiotherapy, followed by excision and adjuvant chemotherapy. Seven months after completion of treatment, he presented with an abdominopelvic mass and soft tissue peritoneal deposits. The mass was resected, and second line chemotherapy resulted in a partial response. The patient was routinely followed. Six months after completion of the second round of chemotherapy, CECT showed multiple soft tissue deposits in the right lumbar region, right hemipelvis, and presacral region with no evidence of pulmonary disease. Chemotherapy elicited a partial response. Three years from the date of diagnosis, the patient was alive with stable disease. Conclusion: This case is unique because of the rare primary site of PLS presentation and the rare presentation of peritoneal metastasis. Citing such cases would help us to define adequate treatment protocols for this aggressive tumor.

Pleomorphic Liposarcoma Unraveled: Investigating Histopathological and Immunohistochemical Markers for Tailored Diagnosis and Therapeutic Innovations

“…However, researchers suggest that pre-operative radiotherapy should be taken into consideration in these malignant lesions, in order to reduce the tumor volume and obtain surgical resection margins [ 69 ]. Among pleomorphic liposarcomas with peculiar locations, malignant adipocytic tumors of the viscera require special attention [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. We identified two primary pleomorphic liposarcomas of the lung, reported by Li B. et al and Dey T. et al, both of them identified in male patients with no history of smoking or alcohol abuse [ 71 , 72 ].…”

“…Among pleomorphic liposarcomas with peculiar locations, malignant adipocytic tumors of the viscera require special attention [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. We identified two primary pleomorphic liposarcomas of the lung, reported by Li B. et al and Dey T. et al, both of them identified in male patients with no history of smoking or alcohol abuse [ 71 , 72 ]. The patients presented with shortness of breath and chest pain, and the tumors were described as large, hypodense masses identified using a CT scan [ 71 , 72 ].…”

“…We identified two primary pleomorphic liposarcomas of the lung, reported by Li B. et al and Dey T. et al, both of them identified in male patients with no history of smoking or alcohol abuse [ 71 , 72 ]. The patients presented with shortness of breath and chest pain, and the tumors were described as large, hypodense masses identified using a CT scan [ 71 , 72 ]. The two patients received chemotherapy, followed by surgical resection; however, one of them developed a retroperitoneal metastasis 7 months after treatment [ 72 ].…”

“…The patients presented with shortness of breath and chest pain, and the tumors were described as large, hypodense masses identified using a CT scan [ 71 , 72 ]. The two patients received chemotherapy, followed by surgical resection; however, one of them developed a retroperitoneal metastasis 7 months after treatment [ 72 ]. Upon histopathological examination, both lesions were highly suggestive of pleomorphic liposarcoma [ 71 , 72 ].…”

“…The two patients received chemotherapy, followed by surgical resection; however, one of them developed a retroperitoneal metastasis 7 months after treatment [ 72 ]. Upon histopathological examination, both lesions were highly suggestive of pleomorphic liposarcoma [ 71 , 72 ]. An ancillary study revealed intense S100 positivity and a mutant p53 immunophenotype within the tumor cells of both lesions described above [ 72 ].…”