Abstract:

Objective

To explore the diagnosis and treatment of liposarcoma of urogenital system， improve the comprehensive understanding of this disease and provide basis for clinical treatment.

Methods

Retrospective analysis was conducted to the clinical characteristics， imaging manifestations，treatment， histological diagnosis and prognosis of 24 cases of liposarcoma of the urogenital system in our hospital from May 2011 to November 2020. Related literatures were systematically analyzed summed up by searching cnKI， Wanfang， Pubmed and other databases. All patients signed informed consent， which was in line with medical ethics regulations.

Results

There were 15 patients with renal or perirenal liposarcoma， including 4 males and 11 females， with a mean age of （56±11） years， and 9 patients with spermatic cord liposarcoma with a mean age of （64±8） years. The tumor diameter of renal or perirenal liposarcoma was （11±4） cm， plain CT 21（-7-36） Hu， enhanced CT 25（40-100） Hu. The tumor diameter of liposarcoma of the sperm cord was （7.2±2.6） cm， plain CT 20（-75-43） Hu， enhanced CT 35（-70-89） Hu.The lesions of 15 patients with renal or perirenal liposarcoma were all large and irregular with high and low mixed density， and 1 case （6.7%） showed patular fat composition. The lesions of the 9 cases of liposarcoma of the spermatic cord were of mass type with regular morphology， clear boundary， medium to low mixed density， and 3 cases （33.3%） showed fat composition， which was mass. In this group of cases， pathological types of renal or perirenal liposarcoma included 11 cases （73.3%） of dedifferentiated liposarcoma， 2 cases（13.3%） of myxoid/round cell liposarcoma， 1 case （6.7%） of atypical lipomatous tumor/well-differentiated liposarcoma， and 1 case （6.7%） of pleomorphic liposarcoma， and liposarcoma of the spermatic cord included 5 cases （55.6%） of atypical lipomatous tumor/well-differentiated liposarcoma， 4 cases （44.4%）of dedifferentiated liposarcoma. CDK4 （+） accounted for 5/5 （100%）， Vimentin （+） accounted for 16/16（100%）， CD34 （+） accounted for 12/17 （70.6%）， SMA （+） accounted for 6/18 （33.3%）， Desmin （-）accounted for 9/9 （100%）. S-100 （-） accounted for 11/17 （64.7%）. The amplification of MDM2 gene detected by fluorescence in situ hybridization （FISH） accounted for 3/4 （75%）. The follow-up time ranged from 7 to 120 months， with an average of （47±23） months. Of the 24 patients with urogenital liposarcoma，10 recurred， 6 underwent secondary surgery， 5 survived， and 4 received follow-up treatment （chemotherapy or radiation）. Five patients died of liposarcoma recurrence during the follow-up period， and the overall average survival time was （38±17） months.

Conclusion

Imaging examination has certain value in the diagnosis and treatment of this disease urogenital liposarcoma. Histopathology， immunohistochemistry and molecular pathology play a key role in the diagnosis of liposarcoma. Surgical resection is the main treatment for liposarcoma and its prognosis is mainly affected by its pathological subtypes.

Key words: Liposarcoma, Urogenital system, Malignant tumor