Case 2: A large myxoid liposarcoma of the pelvis: diagnostic and therapeutic challenge

Muaz Saifeldin Idris, Mohamed Isam Atiatalla, Seifeldin Ibrahim Mahdi, Ahmed Mohamed ElHassan, Mohamed ElMakki Ahmed

Abstract


Background: Sarcomas represents less than 1% of all soft-tissue tumors. Liposarcoma is the second most common soft tissue sarcoma in adults with a myxoid type being the second most common variety. The tumor
can give a misleading benign appearance and hence clinical, imaging, histopathological and histochemical data may be required to settle the diagnosis.
Case presentation: Wereport on a 19-year-old female with recurrent pelvi-perineal giant myxoid liposarcoma. The patient had resection of the swelling four years ago and was reported as angiolipoma. The
current Imaging was suggestive of a benign lesion; however after radical excision the histopathology confirmed a malignant myxoid liposarcoma. Despite complete excision of the lesion, the decision was made to send her
for adjuvant chemo radiotherapy. This was based on the patient’s young age, the huge size, deep location of the tumor and the recurrent nature of the disease. The patient is very well now 12 months following surgery.
Conclusion: A rapidly growing deep gluteal or pelvic mass should raise the suspicion of malignancy.
Imaging including sonography and MRI will depict the size and the deep extension, but may lack further features indicating malignancy. A planned procedure for primary adequate surgical excision should be based on
the whole clinical picture and imaging. Careful histopathological confirmation and close follow up is essential.

*Corresponding author: Department of Surgery, Faculty of Medicine, University of Khartoum, E mail:rasheid@usa.net


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ISSN: 1858-5345