Usuda D, Takeshima K, Sangen R, Nakamura K, Hayashi K, Okamura H, Kawai Y, Kasamaki Y, Iinuma Y, Saito H, Kanda T, Urashima S. Atypical lipomatous tumor in the ligamentum teres of liver: A case report and review of the literature. World J Clin Cases 2018; 6(12): 548-553 [PMID: 30397612 DOI: 10.12998/wjcc.v6.i12.548]
Corresponding Author of This Article
Daisuke Usuda, MD, MTM, PhD, Department of Infectious Diseases, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Ishikawa-ken 920-0293, Japan. united19771108@yahoo.co.jp
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
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Oct 26, 2018 (publication date) through Mar 8, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Usuda D, Takeshima K, Sangen R, Nakamura K, Hayashi K, Okamura H, Kawai Y, Kasamaki Y, Iinuma Y, Saito H, Kanda T, Urashima S. Atypical lipomatous tumor in the ligamentum teres of liver: A case report and review of the literature. World J Clin Cases 2018; 6(12): 548-553 [PMID: 30397612 DOI: 10.12998/wjcc.v6.i12.548]
Daisuke Usuda, Kento Takeshima, Ryusho Sangen, Yuji Kasamaki, Tsugiyasu Kanda, Department of Community Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi-shi, Toyama-ken 935-8531, Japan
Daisuke Usuda, Yasuhiro Kawai, Yoshitsugu Iinuma, Department of Infectious Diseases, Kanazawa Medical University, Uchinada-machi, Ishikawa-ken 920-0293, Japan
Kisuke Nakamura, Kei Hayashi, Hitoshi Saito, Department of General and Digestive Surgery, Kanazawa Medical University Himi Municipal Hospital, Himi-shi, Toyama-ken 935-8531, Japan
Hideyuki Okamura, Sachio Urashima, Department of Gastroenterology, Kanazawa Medical University Himi Municipal Hospital, Himi-shi, Toyama-ken 935-8531, Japan
Author contributions: Usuda D collected the case data, prepared the photos, and wrote the manuscript; all authors proofread the pathologic materials; Takeshima K, Sangen R, Nakamura K, Hayashi K, Okamura H, Kawai Y, Kasamaki Y, Iinuma Y, Saito H, Kanda T and Urashima S proofread and revised the manuscript; all authors approved the final version to be published.
Informed consent statement: Both written and verbal informed consents were obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
Correspondence to: Daisuke Usuda, MD, MTM, PhD, Department of Infectious Diseases, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Ishikawa-ken 920-0293, Japan. united19771108@yahoo.co.jp
Telephone: +81-76-2188452 Fax: +81-76-2188453
Received: June 11, 2018 Peer-review started: June 11, 2018 First decision: June 20, 2018 Revised: July 11, 2018 Accepted: August 11, 2018 Article in press: August 12, 2018 Published online: October 26, 2018 Processing time: 139 Days and 2.2 Hours
ARTICLE HIGHLIGHTS
Case characteristics
A three-month history of persistent epigastralgia and right hypochondralgia.
Abdominal mesenchymoma based on MRI, including of fat suppression radiography.
Pathological diagnosis
Immunohistochemical study of atypical stromal cells, namely tumor cells were positive for MDM2 and CDK4 and negative for α-SMA, S-100 protein, CD34 and STAT-6, which led to the pathological diagnosis of atypical lipomatous tumor (ALT).
Treatment
Surgery.
Related reports
ALT is an intermediate tumor with risk of local recurrence but no potential for metastasis. However, ALT may be difficult to distinguish from benign adipose tumors and poorly differentiated sarcomas. Up to now, MDM2 and CDK4 immunostaining have been particularly useful in separating ALT from the large group of differentiated adipose tumors, and they are important for the differential diagnosis. To date, surgical resection has been the mainstay of curative treatment. Long survival is correlated with the active resection of recurrence and recognition of high-grade dedifferentiated type liposarcoma at an early stage. As far as we know, there have been no reported ALT cases occurring from the ligamentum teres of the liver.
Term explanation
ALT: Atypical lipomatous tumor.
Experiences and lessons
When neoplastic lesion is confirmed by image inspection, we should thoroughly investigate, including further image investigations and pathologic examination. The latter is especially important.
