Cardiac metastases from primary myxoid liposarcoma of the thigh: a case report
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(2020) 18:227
CASE REPORT
Open Access
Cardiac metastases from primary myxoid liposarcoma of the thigh: a case report Kunihiro Ikuta1,2* , Tomohisa Sakai1, Hiroshi Koike1, Tohru Okada3, Shiro Imagama1 and Yoshihiro Nishida1,4
Abstract Background: Myxoid liposarcoma is well known to have an unusual proclivity for extrapulmonary metastasis. However, cardiac metastasis of myxoid liposarcoma is very rare, even in patients with advanced disease. Case presentation: A 40-year-old man was diagnosed with myxoid liposarcoma of the right thigh and treated with wide resection. Two years after the surgery, a low-density area in the left ventricle was found on follow-up chest computed tomography, and was suspected of being metastatic disease. He underwent surgical treatment, and the lesion was pathologically confirmed as metastasis of myxoid liposarcoma. Fifteen months later, he complained of slight dyspnea and developed metastatic disease in the right atrium. He was treated with surgical excision, followed by radiotherapy. Although there was no recurrence in the heart since the second cardiac metastasectomy, multiple metastases occurred in the abdominal cavity, lungs, and muscles. He finally died of the disease 2 years after the second cardiac metastasectomy. Conclusion: We experienced a case of primary myxoid liposarcoma in the thigh, accompanied by ectopic and metachronous cardiac metastases. Although this condition is rare, we should follow-up patients with myxoid liposarcoma, considering the possibility of cardiac metastasis. Keywords: Cardiac metastasis, Myxoid liposarcoma, Extrapulmonary metastasis
Background Myxoid liposarcoma (MLS) is the second most common subtype of liposarcoma arising in children, adolescents, and young adults [1]. MLS usually occurs in deep tissues of the extremity, especially in the thigh. Some tumors have round cell areas that represent histologic progression to high-grade tumors. Round cells, defined as greater than 5% of the total cells, are associated with higher malignancy and metastatic potential, resulting in an unfavorable outcome in patients with MLS [2, 3]. MLS is known as a translocation-related sarcoma and has a translocation with FUS-DDIT3 or rarely EWSR1* Correspondence: [email protected] 1 Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa, Nagoya 466-8550, Japan 2 Medical Genomics Center, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya 466-8550, Japan Full list of author information is available at the end of the article
DDIT3 fusion. Since the fusion protein resulting from these fusion genes acts as activated and deregulated transcriptional factors, it stimulates the proliferation of tumor cells [4]. Approximately one third of patients with MLS develop distant metastatic spread [5, 6]. Patients with MLS tend to have metastases to extrapulmonary sites, such as retroperitoneum, abdominal wall, abdominal cavity, and bone, even in the absence of pulmonary metastases [2, 7]. Although several authors have r
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