SURG-30 A Case of Emergent Metastatic Liposarcoma invading the Central Nervous System: A Case Report and Review of the Literature A Case of Emergent Metastatic Liposarcoma invading the Central Nervous System: A Case Report and Review of the Literature

This is the authors' abstract. We don't add key points for this paper.

Introduction Liposarcoma (LS) is a rare soft-tissue sarcoma arising from lipoblasts. It is most common in older populations, with an average age of diagnosis of 50 years of age. LS is most common in the extremities and retroperitoneum, and Central Nervous System (CNS) metastases of this malignancy are rare. Surgery, radiotherapy, and chemotherapy form the main treatment options. Methods We present a case of a 59-year-old woman with dual intracranial and spinal metastases of a pelvic myxoid pleomorphic liposarcoma. Results A 59-year old woman with a 9-month history of stage IV pelvic myxoid pleomorphic liposarcoma presented with weakness in lower and upper extremities and a visible metastatic deposit in the scalp. Imaging revealed a mass involving the right parietal bone with an intracranial component causing compression of frontoparietal lobes. The patient underwent an uncomplicated craniotomy and initially demonstrated improved strength in her extremities, but experienced sudden reversal and resurgent weakness in lower extremities ipsilateral to the lesion the same afternoon. Further imaging revealed innumerable osseous metastasis to the spine at nearly every lumbar and thoracic level with severe spinal cord compression at T4 vertebrae. A T4 hemilaminectomy and tumor resection was conducted, with improvements to sensation but no return of function to lower extremities. As of two weeks postoperatively, she was discharged and resumed chemotherapy. Conclusion Liposarcomas are uncommon malignancies with exceedingly rare presentations of metastasis to the central nervous system. Improvements to treatment of LS have extended mean survival time, raising the potential for metastasis to CNS. In this case, a seemingly straightforward diagnosis of brain metastasis obscured additional spinal masses, leading to a surprising and almost immediate return of neurological symptoms. Diagnosis of and treatment of neurological symptoms associated with metastatic liposarcoma should consider the possibility of both brain and spinal lesions.