Dermal pleomorphic liposarcoma resembling pleomorphic fibroma: report of a case and review of the literature

Authors

  • Tariq Al-Zaid,

    1. Department of Pathology, Tufts Medical Center, Boston, MA, USA
    Search for more papers by this author
    • Present address: Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Gretchen Frieling,

    Corresponding author
    1. Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
    • Department of Pathology, Tufts Medical Center, Boston, MA, USA
    Search for more papers by this author
  • Seth Rosenthal

    1. Department of Dermatopathology, Caris Life Sciences, Newton, MA, USA
    Search for more papers by this author

  • Presented as a poster at Symposium XXX of the International Society of Dermatopathology (ISDP) in Santiago, Chile; October 28–31, 2009.

Gretchen Frieling, MD,

Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Brookline, MA 02215, USA

Tel: +1 617 667 4344

Fax: +1 617 667 7120

e-mail: gewillia@bidmc.harvard.edu

Abstract

Pleomorphic liposarcoma (PLPS) is a rare, high-grade sarcoma defined by the presence of pleomorphic lipoblasts. Constituting 5% of all liposarcomas, PLPS usually arises in deep soft tissues of the extremities, with rare occurrences in the dermis and subcutis. We describe a unique case of an 85-year-old Caucasian gentleman with a 1 year history of a pedunculated, pink, non-tender papule on the dorsum of his left arm, measuring 1.0 cm in maximum dimension. Biopsy revealed a dermal collection of atypical epithelioid and spindle cells superimposed on a sclerotic background, resembling a pleomorphic fibroma on low power. On high power, a central focus of discrete adipocytic differentiation with pleomorphic lipoblasts was present. Tumor cells were positive for S-100 and negative for desmin, actin, CD68, keratin, MART-1 and CD34. Clinicopathologic findings were consistent with PLPS and the diagnosis was made. PLPS is rarely localized to the dermis and one with low power features resembling a pleomorphic fibroma has not been previously described in the literature.

Ancillary