Soft Tissue Sarcoma with Jonathan C. Trent, MD, PhD and Shreyaskumar R. Patel, MD: Case 2 - Episode 3
What is notable about the pattern of this patient's metastatic disease?
Mixoid liposarcoma is an interesting entity in that this is a tumor that ends up metastasizing to other fat bearing areas in the body. If you back up a step and look at all extremity soft tissue sarcomas, the metastatic pattern is generally going to be lung dominant, with lungs as the favorite first and most common site of disease. Mixoid liposarcoma is an exception in the sense that it can go to fat bearing areas.
This is one tumor where a CT scan of the abdomen and pelvis would be indicated as part of the staging workup to pick up a metastatic lesion in the perinephric or the retroperitoneal fat, for example, that may otherwise be asymptomatic and could not be picked up on physical exam. Mixoid liposarcomas tend to go to fat bearing areas.
CASE: Soft-Tissue Sarcoma Case 2
Michael C is a 59-year-old social worker from Los Angeles California; his medical history is notable for obesity, COPD, and mild hypertension.
In September of 2014, Michael returns for follow up and his CT scan shows a 4 cm posterior mediastinal mass, and a 6 cm perinephric mass suspicious for metastatic disease. He initiates treatment with anthracycline and ifosfamide chemotherapy (6 cycles) for recurrent disease and shows a partial response.