Brain Metastasis of Primary Dedifferentiated Liposarcoma. A Case Report and Review of Literature
Liposarcomas are rare tumors representing less than 1% of all malignancies. It is the second most common soft tissue malignancy diagnosed in adults. It is divided into various groups based on histological differences including well differentiated liposarcoma (WDL), dedifferentiated liposarcoma (DDL), myxoid liposarcoma and polymorphic liposarcoma.
This case focuses on dedifferentiated type (DDL) which is described as WDL with abrupt transition into high grade, non-lipogenic tumor. DDLs are known to mostly occur within the retroperitoneum and have a low rate of metastasis. The lungs are the most common site of metastasis while brain metastasis is rare.
Due to the rarity of this case, a literature review was done which revealed five similar cases showing brain metastasis. Primary sites for these metastases ranged from extremities including digit to the heart. The cases reviewed featured men above 50 years of age however age ranged from 17 to 63 years old. There was notable variability in the presenting neurological symptoms based on the site of the distant metastasis and brain metastasis was noted to be a poor prognostic factor.
It is therefore imperative to have a high index of suspicion for metastasis in DDL and more research is needed to understand the pattern of metastasis to better guide management and ensure early intervention.