Key result
Anthracycline-based chemotherapy reduced the unresectable liver metastasis by 50%, enabling successful right hemihepatectomy with no recurrence at 5 months.
Why the study?
Solitary liver metastasis from primary extremity pleomorphic liposarcoma is extremely rare, pleomorphic liposarcomas are generally unresponsive to chemotherapy and radiotherapy, and information on appropriate management is limited.
Case Report (n=1)
No
Chemotherapy and conversion surgery can be an effective treatment strategy for unresectable metastatic liver tumors originating from primary pleomorphic liposarcoma.
May support conversion surgery after chemotherapy in select unresectable metastatic pleomorphic liposarcoma; hypothesis-generating and requires prospective validation.
BACKGROUND: Pleomorphic liposarcoma is the rarest subtype of liposarcoma. Pleomorphic liposarcomas are generally unresponsive to chemotherapy and radiotherapy. Moreover, metastasis in the liver, as the first and sole site, from a primary extremity soft tissue sarcoma, including pleomorphic liposarcoma, is extremely rare. Information regarding the appropriate management of these lesions is limited. CASE PRESENTATION: A 50-year-old Japanese woman presented with a mass in the left thigh. Imaging examination revealed a soft tissue sarcoma on the left posterior thigh. The tumor was histologically diagnosed as pleomorphic liposarcoma. Computed tomography examination for assessment of metastases incidentally detected a huge liver mass. Wide excision of sarcoma was performed prior to chemotherapy. Right trisectionectomy was necessary to achieve hepatic clearance; however, the future liver remnant volume was insufficient. Therefore, we decided to administer anthracycline-based chemotheraphy to shrink the tumor. After seven courses of adriamycin-based chemotherapy, the liver tumor size was reduced from 211 mm × 106 mm × 180 mm to 105 mm × 66 mm × 90 mm. Finally, a right hemihepatectomy was performed. The patient was continuously monitored and was metastasis or local recurrence free within 5 months after liver surgery. CONCLUSION: Chemotherapy is effective in some cases for the treatment of unresectable liver metastases of pleomorphic liposarcoma, and complete resection is possible with conversion surgery. If the patient's general condition permits, anthracycline-based chemotherapy can be used for the treatment of stage 4 pleomorphic liposarcoma.
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Shimomura et al. (2023) conducted a case report in Pleomorphic liposarcoma with liver metastasis (n=1). Conversion surgery combined with adjuvant chemotherapy was evaluated on Tumor size reduction and recurrence-free survival. Anthracycline-based chemotherapy reduced the unresectable liver metastasis by 50%, enabling successful right hemihepatectomy with no recurrence at 5 months.
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