Giant dedifferentiated liposarcoma of the neck with osteosarcoma and chondrosarcoma components: A case report

Dedifferentiated liposarcoma (DDLPS) is a subtype of LPS characterized by two distinct levels of differentiation and morphological structures, comprising areas of well-differentiated LPS and dedifferentiated, non-lipogenic, highly malignant components. DDLPS most frequently occurs in the retroperitoneum and the soft tissues of the pelvis and limbs, and is rare in the head and neck region, accounting for only 1% of head and neck sarcomas. The present study describes the case of a 72-year-old male with a 30-year history of left upper limb numbness and heaviness. During physical examination, a tumor measuring similar to 13x22 cm was discovered in the left posterior region of the head and neck. The mass was hard in texture and had limited mobility. A biopsy of the lesion revealed a mesenchymal tumor rich in adipose components with ossification, containing heterologous elements primarily indicative of osteosarcoma, highly suggestive of DDLPS. A radical excision of the tumor was subsequently performed. The surgical specimen exhibits cross-sections with a gray-white to gray-yellow solid consistency, featuring gray-white, semi-transparent areas resembling cartilage. Immunohistochemical staining was positive for murine double minute 2 (MDM2), cyclin-dependent kinase 4 (CDK4), P16, P53, Vimentin and Ki-67, and negative for cytokeratin pan, S-100, CD34 and smooth muscle actin. Fluorescence in situ hybridization results indicated amplification of the MDM2 and CDK4 genes. In the present study, a case of a large DDLPS in the neck with components of osteosarcoma and chondrosarcoma was reported. There was no recurrence during the follow-up period. The pathological characteristics, diagnosis and current treatment methods for DDLPS were also described. Although cases of DDLPS have been reported, the number of cases described at this site remains limited to date, and it is currently not possible to accurately predict the treatment efficacy and prognosis.