Colossal well-differentiated liposarcoma of the small bowel mesentery: A case report

Figure 1 Abdominal physical examination preoperatively. A: The patient had obvious abdominal distension (frog-belly); B: The measured abdominal girth was 109 centimeters.

Figure 2 Abdominal and pelvic magnetic resonance imaging scan indicated that multiple round masses were found in the abdominal cavity with an envelope, and occupy the entire abdominal cavity, which originated from the small bowel mesentery. Tremendous masses, well circumscribed, lobulated, heterogeneous mass, compartmentalized, with a maximum size of 25 cm × 23 cm × 15 cm (mark with orange lines). A: Coronal position; B: Sagittal position; C: Transverse position T2 weighted image; D: Transverse position T1 weighted image.

Figure 3 Resected specimen, macroscopic findings. A: The heterogeneous and multifocal masses found during laparotomy, all masses approximately 11 kg in weight; B: The mass cut surface was soft, white to yellow and without necrotic, without invasion into the mucosal surface of the small intestine.

Figure 4 Pathological examination results. Histopathological examination showed hematoxylin and eosin stains (× 40). Microscopic examination of the mesenteric mass showing variably sized lipoblasts with vacuolated cytoplasm, central hyperchromatic nuclei and nuclear scalloping. Histopathologic features of well-differentiated liposarcoma. A-F: Immunohistochemical stain is positive for the neoplastic cells. Positive: MDM2 (A), S-100 (B), P16 (C), Vim (D), Ki-67 (3%; E), and p53 (F); G and H: Immunohistochemical stain is negative [CK-pan (G) and EMA (H)]; I and J: Fluorescence in situ hybridization showed that MDM2 gene amplification is further confirmed (red signals represent MDM2; green signals represent chromosome 12 centromeres; magnification: × 400).