Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2022; 10(6): 2007-2014
Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.2007
Primary duodenal dedifferentiated liposarcoma: A case report and literature review
Nah Ihm Kim, Ji Shin Lee, Chan Choi, Jong Hee Nam, Yoo Duk Choi, Hee Joon Kim, Sung Sun Kim
Nah Ihm Kim, Jong Hee Nam, Yoo Duk Choi, Sung Sun Kim, Department of Pathology, Chonnam National University Hospital, Gwangju 61469, South Korea
Ji Shin Lee, Chan Choi, Department of Pathology, Chonnam National University Hwasun Hospital, Hwasun 58128, South Korea
Hee Joon Kim, Department of Surgery, Chonnam National University Hospital, Gwangju 61469, South Korea
Author contributions: Kim NI, Choi YD, and Kim SS conceptualized the manuscript; reviewed the literature; and interpreted the H&E slides, immunohistochemistry slides, and fluorescence in situ hybridization; Lee JS, Choi C, and Nam JH contributed to the manuscript draft; Kim HJ contributed to the operative performance; all authors read and approved the final manuscript.
Supported by Grant from Chonnam National University Hospital Biomedical Research Institute, No. CRI17004-1.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sung Sun Kim, MD, PhD, Associate Professor, Department of Pathology, Chonnam National University Hospital, No. 42 Jebong-ro, Gwangju 61469, South Korea. succeedsoon@hanmail.net
Received: September 1, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Liposarcoma; Primary; Small bowel; Duodenum; Immunohistochemistry; Case report

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.