A rare case of dedifferentiated liposarcoma of the sinonasal cavity: A case report

Miyazaki,Masaru; Aoki,Mikiko; Oba,Satoru; Sakata,Toshifumi; Nakagawa,Takashi; Nabeshima,Kazuki

doi:10.3892/mco.2017.1379

A rare case of dedifferentiated liposarcoma of the sinonasal cavity: A case report

Authors:
- Masaru Miyazaki
- Mikiko Aoki
- Satoru Oba
- Toshifumi Sakata
- Takashi Nakagawa
- Kazuki Nabeshima
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Affiliations: Department of Pathology, Fukuoka University School of Medicine, Fukuoka 814‑0180, Japan, Department of Otorhinolaryngology and Head and Neck Surgery, Fukuoka University School of Medicine, Fukuoka 814‑0180, Japan
Published online on: August 18, 2017 https://doi.org/10.3892/mco.2017.1379
Pages: 539-542
Copyright: © Miyazaki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Sarcoma is an uncommon histopathological presentation of sinonasal tumors, comprising ~15% of all cases; liposarcoma is particularly uncommon. An analysis of the available medical literature revealed no prior reports of dedifferentiated liposarcoma (DDLPS) of the sinonasal cavity. This case report presents a rare case of DDLPS of the sinonasal cavity. A 40‑year old six‑week pregnant female was admitted with a left nasal obstruction. Endoscopic evaluation of the left nasal cavity revealed a polypoid lesion. A computed tomography scan indicated a mass invading the left nasal cavity, maxillary sinus and anterior ethmoid sinus with focal destruction of the surrounding bone. A biopsy of the tumor was performed and hematoxylin and eosin staining of the tissue sections revealed proliferation of atypical and pleomorphic spindle cells with enlarged or elongated hyperchromatic nuclei and occasional vacuolated cytoplasm arranged in short interlacing fascicles or storiform structures, accompanied by tumor necrosis. These findings were consistent with undifferentiated pleomorphic sarcoma. Immunohistochemically, the tumor cells were positive for cyclin dependent kinase 4, mouse double minute 2 homolog (MDM2) and adipophilin. Fluorescence in situ hybridization (FISH) analysis revealed amplification of the MDM2 gene. Recently, undifferentiated pleomorphic sarcoma without areas of well‑differentiated liposarcoma but with MDM2 amplification is regarded as conventional DDLPS. In the present case, the tumor was diagnosed as a DDLPS due to the results of histopathological, immunohistochemical and FISH analysis.

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