Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.2007
Peer-review started: September 1, 2021
First decision: October 18, 2021
Revised: October 27, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 26, 2022
Processing time: 175 Days and 7.2 Hours
Dedifferentiated liposarcoma (DDLPS) is an extremely rare neoplasm that exhibits various morphologies. The tumor is characterized by immunoreactivity to MDM2 and CDK4 and can be confirmed by detecting MDM2 amplification via fluorescence in situ hybridization (FISH). Herein, we report an unusual case of DDLPS arising from the duodenum.
A 64-year-old man presented with repeated abdominal pain and weight loss. Radiologic studies revealed a mass of the duodenum involving the pancreas. The patient was treated with pylorus-preserving pancreaticoduodenectomy. Histologically, the tumor showed a high-grade sarcoma. Immunohistochemistry demonstrated that the tumor cells were positive for MDM2 and CDK4 expression. MDM2 amplification was detected via FISH, leading to the final diagnosis of DDLPS. Following surgery, the patient was treated in the intensive care unit due to peritonitis, and died 60 d after surgery.
To the best of the authors’ knowledge, this is the first case of primary duodenal DDLPS in Korea and the third case in the English-language literature. Care must be taken not to misdiagnose DDLPS as another high-grade tumor. Liposarcoma should be in the differential diagnosis list.
Core Tip: Primary dedifferentiated liposarcoma (DDLPS) originating from the duodenum are rare and can be diagnosed based on histology, immunohistochemistry and MDM2 amplification via fluorescence in situ hybridization. Differential diagnoses are required along with consideration of DDLPS.