case_images: PMC10691830_01
case_images: CT images at the initial visit. Tumors were observed on the left chest wall (a), perigastric area (arrow) (b), ileocecal area (arrow) and right buttock (c), left buttock (d), right thigh (e), left thigh (f), right lower leg (g), and left lower leg (h). Multiple ossifications were found in the tumor on the left lower leg. CT, computed tomography.
case_images: cro-2023-0016-0001-534181_F01.jpg
case_images: PMC10691830_01_cro-2023-0016-0001-534181_F01.jpg
case_images: F1
case_images: Cooperative Oncology Group Performance Status [PS] 4), with limitations in physical movement due to the large tumor size. Computed tomography (CT) revealed multiple adipocytic lesions in the chest wall, bilateral groins, thighs, lower legs, perigastric tissue, and ileocecal region (shown in Fig. 1).
case_images: Surgical findings. Six tumors, weighing 17 kg in total, were resected. Preoperative (a, b) and intraoperative findings (c). Tumors were resected from the sartorius (d), vastus intermedius (e), adductors (f), distal and proximal hamstrings (g, h), and popliteal fossa (i).
case_images: cro-2023-0016-0001-534181_F02.jpg
case_images: PMC10691830_01_cro-2023-0016-0001-534181_F02.jpg
case_images: F2
case_images: In the first surgery, six tumors weighing 17 kg were resected from the right thigh (shown in Fig. 2).
case_images: Pathological and FISH findings of resected specimens. a Histopathological findings of the scrotal tumor (H&E, x100). No obvious dedifferentiated components were observed. b Histopathological findings of the perigastric tumor included two images corresponding to ALT/WDLPS and a dedifferentiated component with myxoid liposarcoma-like histology (H&E, x40). c FISH findings in the perigastric tumor revealed MDM2 amplification (red).
case_images: cro-2023-0016-0001-534181_F03.jpg
case_images: PMC10691830_01_cro-2023-0016-0001-534181_F03.jpg
case_images: F3
case_images: Radiological images of the primary scrotal liposarcoma from another hospital were unavailable; however, a review of histopathological specimens from the initial surgery revealed no obvious dedifferentiated components (shown in Fig. 3a). Histopathological analyses of the resected tumors revealed that only five specimens had dedifferentiated components in four locations: the left lower leg (two surgeries), perigastric tissue (shown in Fig. 3b), right lower leg, and left thigh, with the remaining specimens being ALT/WDLPS. Fluorescence in situ hybridization for MDM2 and DDIT3 in the perigastric tumor revealed MDM2 amplification (shown in Fig. 3c) without DDIT3 translocation.
case_images: PMC10691830_02