Renal liposarcoma

Because people nowadays do not pay attention to diet and healthy lifestyle, more and more people are suffering from tumor diseases. Among them, renal liposarcoma, as a tumor disease that poses a greater threat to human health, is feared by everyone. However, I believe that many people are not familiar with the disease of renal liposarcoma, or even feel unfamiliar with it. Let’s take a look at how renal liposarcoma is diagnosed and treated.

Liposarcoma

Liposarcoma is the most common soft tissue sarcoma in adults and can also occur in adolescents and children. Liposarcomas are usually large, deep, painless, gradually enlarging masses that most commonly occur in the lower extremities (eg, popliteal fossa and inner thigh), retroperitoneum, perinephric and mesenteric regions, and shoulders. The incidence in different sites depends mainly on the subtype of the tumor, which includes atypical lipomatous tumor/well-differentiated liposarcoma, dedifferentiated liposarcoma, myxoid liposarcoma, pleomorphic liposarcoma, and mixed liposarcoma.

Clinical manifestations

Liposarcomas are usually large, deep, painless, gradually enlarging masses that most commonly occur in the lower extremities (eg, popliteal fossa and inner thigh), retroperitoneum, perinephric and mesenteric regions, and shoulders.

diagnosis

The diagnosis can be made based on clinical manifestations, gross examination, and histopathology. Below we will describe the different types of liposarcoma.

1. Atypical lipomatous tumor/well-differentiated liposarcoma

It is often a large, well-defined, lobulated mass. Microscopically, ALT/WD liposarcoma is composed of relatively mature hyperplastic adipose tissue, and the cell size is significantly different from that of benign lipoma. Focal nuclear atypia and hyperchromasia of adipocytes aid in diagnosis. Scattered hyperchromatic interstitial cells and multinucleated interstitial cells are common. Varying numbers of single or multivesicular lipoblasts can be seen. These include sclerosing liposarcoma, inflammatory liposarcoma, and spindle cell subtypes, and heterologous differentiation may also occur.

2. Dedifferentiated liposarcoma

It is generally a large, multinodular, xanthomas with scattered, solid, often gray-brown, nonfatty areas. Areas of dedifferentiation are often necrotic. Its histological feature is the migration of ALT/WD liposarcoma to non-lipid sarcoma (mostly highly malignant). 5% to 10% of dedifferentiated liposarcoma may have heterogeneous differentiation, but it has nothing to do with clinical prognosis. The most common differentiation is muscular or bone/chondrosarcoma differentiation.

3. Myxoid liposarcoma

MLS typically presents as a large, painless, well-circumscribed, multinodular mass deep in the soft tissues of the extremities. Low-grade malignant tumors have a brown, jelly-like cross-section. The highly malignant round cell areas are white and fleshy. There is often no visible necrosis. Under low magnification, MLS showed a lobed structure, with abundant cells in the peripheral part of the lobule. There is a mixture of uniformly round and oval primitive non-fat mesenchymal cells and small signet ring-shaped lipoblasts. The stroma is obviously myxoid and has abundant fine, bud-like, "reticular" capillary networks. Interstitial bleeding is common. MLS often shows a gradual transition between myxoid and cellular/round cell areas.

High-grade histological grade, necrosis, and high TP53 expression indicate a poor prognosis.

4. Pleomorphic liposarcoma

The tumor is hard, often nodular, and white to yellow in cross section. Most tumors were composed of pleomorphic spindle-shaped tumor cells and fascicles of spindle-shaped and smaller round cells, intermixed with multinucleated giant cells and pleomorphic multivacuolated lipoblasts.

Immunophenotype

S100 protein and vimentin were often expressed, and CD34 was positive in scattered foci.

treat