Pleomorphic liposarcoma:: Clinicopathologic, immunohistochemical, and follow-up analysis of 63 cases -: A study from the French Federation of Cancer Centers Sarcoma Group

被引:177
作者
Gebhard, S
Coindre, JM
Michels, JJ
Terrier, P
Bertrand, G
Trassard, M
Taylor, S
Château, MC
Marquès, B
Picot, V
Guillou, L
机构
[1] Univ Lausanne, Inst Pathol, CH-1011 Lausanne, Switzerland
[2] Univ Hosp Geneva, Dept Pathol, Geneva, Switzerland
[3] Bergonie Inst, Bordeaux, France
[4] Univ Bordeaux 2, F-33076 Bordeaux, France
[5] Inst Gustave Roussy, Villejuif, France
[6] Francois Baclesse Canc Ctr, Caen, France
[7] Paul Papin Canc Ctr, Angers, France
[8] Rene Huguenin Canc Ctr, St Cloud, France
[9] Ctr Val Aurelle, Montpellier, France
[10] Claudius Regaud Canc Ctr, Toulouse, France
关键词
soft tissue neoplasms; pleomorphic liposarcoma; liposarcoma; pathology; immunohistochemistry; prognosis;
D O I
10.1097/00000478-200205000-00006
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The clinicopathologic and immunohistochemical features of 63 pleomorphic liposarcomas are presented, There were 35 men and 28 women (median age 63 years; range 18-93 years). Tumor size ranged from 2 to 23 cm (median 10 cm). Tumor locations included lower extremity (36.5%), especially the thigh (28.5%), limb girdles (17.5%), upper extremity (16%), thoracoabdominal wall (9.5%), and internal trunk (20.5%). A total of 75% were deep seated and/or extracompartmental. Histologically, lesions show a varying combination of lipogenic and nonlipogenic areas characterized by malignant fibrous histiocytoma-like, round cell liposarcoma-like, and/or epithelioid/carcinoma-like features. A pericytic pattern was focally present in 15 (24%) tumors. Eighteen (29%) lesions were grade 2, and 45 (71%) were grade 3 sarcomas. Tumor necrosis was observed in 51 (81%) cases, vascular invasion in three, and mitotic counts ranged from 3 to 124 per 10 high power fields (median 25). Lipogenic areas were S-100 protein immunoreactive, at least focally, in 20 of 42 (48%) cases. Nonlipogenic areas showed focal reactivity for smooth muscle actin (24 of 49; 49%), desmin (9 of 48; 19%), CD34 (18 of 45; 40%), S-100 protein (5 of 49, 10%), CD68 (6 of 46, 13%), and epithelial membrane antigen (13 of 49, 26.5%). Epithelioid areas showed epithelial membrane antigen (4 of 11; 36%) but not cytokeratin (0 of 11) reactivity. Treatment procedures in 51 patients consisted of simple tumorectomy (16) and wide excision (33). Five and 31 patients received neoadjuvant and adjuvant chemotherapy and/or radiation therapy, respectively. Follow-up (48 patients, range 7-276 months; median 38 months) showed a 45% local recurrence rate and a 42.5% metastasis rate, metastases occurring mostly in lungs and pleura. Seventeen patients (35%) died of disease, of whom none was metastatic at diagnosis. Five-year overall, metastasis-free, and local recurrence free survivals were 57%, 50%, and 48%, respectively. Patient age greater than or equal to60 years, truncal tumor location, deep situation, tumor size >5 cm, vascular invasion, and incomplete tumor excision were significant adverse prognostic factors. Tumor grade and histology did not affect patient outcome. In conclusion, pleomorphic liposarcoma is a rare, often deep-seated and limb-based aggressive and metastasizing neoplasm of late adulthood. It shows a wide range of morphologic appearances, but tumor grade and histology have no effect on patient outcome.
引用
收藏
页码:601 / 616
页数:16
相关论文
共 47 条
[1]   Intrathoracic pleomorphic liposarcoma in a child: Study of an unusual case [J].
Ali, SZ ;
Teichberg, S ;
Kahn, E ;
Hajdu, SI .
PEDIATRIC PATHOLOGY & LABORATORY MEDICINE, 1996, 16 (01) :99-105
[2]   Aberrant cytokeratin subset immunoreactivity in sarcomas using a large panel of cytokeratin subset antibodies [J].
Alobeid, B ;
Brooks, JJ ;
Zhang, PJ .
APPLIED IMMUNOHISTOCHEMISTRY, 1998, 6 (03) :154-157
[3]  
ARBABI L, 1982, CANCER, V49, P878, DOI 10.1002/1097-0142(19820301)49:5<878::AID-CNCR2820490510>3.0.CO
[4]  
2-R
[5]   ATYPICAL AND MALIGNANT NEOPLASMS SHOWING LIPOMATOUS DIFFERENTIATION - A STUDY OF 111 CASES [J].
AZUMI, N ;
CURTIS, J ;
KEMPSON, RL ;
HENDRICKSON, MR .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1987, 11 (03) :161-183
[6]   CASE-REPORT 172 - PLEOMORPHIC LIPOSARCOMA, GRADE-IV, OF THE SOFT-TISSUE, ARISING IN GENERALIZED PLEXIFORM NEUROFIBROMATOSIS [J].
BAKER, ND ;
GREENSPAN, A .
SKELETAL RADIOLOGY, 1981, 7 (02) :150-153
[7]  
CHANG HR, 1989, CANCER, V64, P1514, DOI 10.1002/1097-0142(19891001)64:7<1514::AID-CNCR2820640726>3.0.CO
[8]  
2-2
[9]   Prognostic factors in adult patients with locally controlled soft tissue sarcoma: A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group [J].
Coindre, JM ;
Terrier, P ;
Bui, NB ;
Bonichon, F ;
Collin, F ;
LeDoussal, V ;
Mandard, AM ;
Vilain, MO ;
Jacquemier, J ;
Duplay, H ;
Sastre, X ;
Barlier, C ;
HenryAmar, M ;
Lesech, JM ;
Contesso, G .
JOURNAL OF CLINICAL ONCOLOGY, 1996, 14 (03) :869-877
[10]  
DAGOSTINO AM, 1963, CANCER, V16, P1015, DOI 10.1002/1097-0142(196308)16:8<1015::AID-CNCR2820160808>3.0.CO