Journal article
Atypical lipomatous tumour/well‐differentiated liposarcoma and de‐differentiated liposarcoma in patients aged ≤ 40 years: a study of 116 patients
Histopathology, Vol.75(6), pp.833-842
12/2019
DOI: 10.1111/his.13957
PMID: 31471922
Abstract
Aims
Limited data exist on atypical lipomatous tumour (ALT)/well-differentiated liposarcoma (WDL) and de-differentiated liposarcoma (DDLPS) in children and young adults.
Methods and results
Cases of ALT/WDL/DDLPS arising in patients aged ≤ 40 years were collected from multiple institutional and consultation archives. A total of 116 cases of ALT/WDL (75) and DDLPS (41) were identified, representing fewer than 5% of these tumours seen at our institutions during this time-period. The patients (59 male/57 female) ranged in age from 8 to 40 years. Sites included deep central (abdomen/retroperitoneum/pelvis/groin) (n = 60), extremity (n = 42), trunk (n = 5), head/neck (n = 8) and mediastinum (n = 1). De-differentiated patterns included: high-grade pleomorphic sarcoma, myxofibrosarcoma-like, heterologous rhabdomyoblastic differentiation, low-grade spindle cell sarcoma and homologous lipoblastic differentiation. Forty-one patients experienced a local recurrence and 11 patients with DDLPS developed metastasis. ALT arising in the extremities had lower recurrence rates than deep central WDL (5-year recurrence-free survival 88.9% versus 59.0%; P = 0.002), while patients with deep central DDLPS experienced significantly more adverse events compared to WDL at this site (5-year event-free survival 11.9% versus 59.0%) (P < 0.0001). Seven (of eight) head/neck tumours had follow-up available; five recurred, and one patient (DDLPS) with recurrence also experienced a metastasis. The single mediastinal tumour (DDLPS) recurred and metastasised.
Conclusion
ALT/WDL and DDLPS occurring in patients aged ≤ 40 years is rare, but exhibits similar morphological features to its counterparts in older adults, including potential for heterologous and homologous de-differentiation in the latter. Although case numbers are limited, tumours arising in the head and neck exhibit high rates of adverse events, suggesting that classification as WDL rather than ALT is more appropriate.
Details
- Title: Subtitle
- Atypical lipomatous tumour/well‐differentiated liposarcoma and de‐differentiated liposarcoma in patients aged ≤ 40 years: a study of 116 patients
- Creators
- Rebecca Waters - Mayo ClinicAndrew Horvai - University of California, San FranciscoPatricia Greipp - Mayo ClinicIvy John - University of PittsburghElizabeth G Demicco - Sinai HospitalBrendan C Dickson - Sinai HospitalMunir R Tanas - University of IowaBrandon T Larsen - Mayo ClinicNasir Ud Din - Aga Khan University HospitalDavid H Creytens - Ghent UniversityArmita Bahrami - Children's Research HospitalLeona A Doyle - Brigham and Women's HospitalVickie Y Jo - Brigham and Women's HospitalAlyaa Al‐Ibraheemi - Boston Children's HospitalKhin Thway - Royal Marsden NHS Foundation TrustSarah M Jenkins - Mayo ClinicBrittany Siontis - Mayo ClinicAndrew Folpe - Mayo ClinicKaren Fritchie - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Histopathology, Vol.75(6), pp.833-842
- DOI
- 10.1111/his.13957
- PMID
- 31471922
- ISSN
- 0309-0167
- eISSN
- 1365-2559
- Grant note
- DOI: 10.13039/100000871, name: Mayo Clinic
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Pathology
- Record Identifier
- 9984186498902771
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