Download - PSO-HNS

type (20%-30% of cases) varies from lipoma-like ceils the response may be striking. Chemotherapy may have
to inflammatory reaction and sclerosis all with bizarre a role in the treatment of liposarcoma. Kindblom et
lipoblasts. Pleomorphic liposarcoma (10%-25% of al in 1977 reported on its use but the series was too
cases) contains an abundant mixture of giant ceils that short to draw any conclusions.
have a dense, glassy, eosinophilic cytoplasm with
bizarre lipoblast and numerous abnormal mitotic fig- A collision tumor is a tumor that is found adjacent
ures. The round cell type (10%-15% of cases) has to and meeting another of different histological type
round to oval cells with multi-vacuolated cytoplasm in the samearea. In our view of foreign literature
and a central round nucleus that may be hyperchro- we see no incidence of a collision tumor involving
matic but marked atypical mitosis are not common, a liposarcoma in the nasal cavity and an undifferentiated
Ca in the nasopharynx.
SURVIVAL AND RECURRENCE RATE
REVIEW OF LOCAL LITERATURE AND CASES
The myxoid and the well-differentiated types have
the best survival rates (75%-100%). The round cell In our review of local literature, we have not yet
ranges from 18%-25%, with the poorest survival rate encountered any case of a llposarcoma occurring in
belonging to the pleomorphic type (0%-21%). The the nasal cavity nor a collision tumor involving limyxoid
and well-differentiated types have the most posarcoma and an undifferentiated Ca. However, upon
recurrence rates (50%-100%) with the pleomorphic retrospective study of liposarcoma (15 years) in two
and round cell ranging from 75%-80%. institutions, we have found only 1 unreported case of
myxoid liposarcoma involving the maxilla.
RATE, INCIDENCE AND SITE OF A review of our slides by different pathologists
METASTASIS in different institutions gave the general consensus of
a collision tumor involving a liposarcoma (myxoid
The rate of metastasis is closely related to the type) of the nasal cavity, with extension to the PNS
degree of histological differentiation. The less dif- and orbit and an undifferentiated carcinoma of the
ferentiated,, the more cellular and the more pleomor- nasopharynx.
phic a given liposarcoma, the more likely it will
metastasize. Apparently, the incidence of metastasis
is dependent to a lesser extent on the location and size CONCLUSION
of the tumor and perhaps also on the mode of therapy.
Sires of metastasis vary considerably. Mostly, poorly We have presented a case of a rare and highly
differentiated types metastasize to the lungs and the malignant collision tumor involving liposarcoma of
visceral organs. Myxoid liposarcomas produce sec- the nasal cavity with extension to the PNS and orbit
ondary lesions on serosal surfaces of pleura, pericar- and an undifferentiated carcinoma of the nasopharynx.
dium and diaphragm and sometimes in the retroperitonium.
A study by Giorgiades et al attempted to In itself, liposarcoma of the nasal cavity is rare
delineate metastasis from aprobable multicentric origin and to our knowledge may be the first reported case
of liposarcoma by presenting 1 case in which they locally and the third reported case internationally.
believe multicentric origin is present, Lymph node Furthermore, when combined with an undifferentiated
metastasis is rare, and if present, indicates advanced Ca of the nasopharynx as a collision tumor makes it
disease,
an even rarer case and thus we believe that this may
be the first reported case of its kind both locally and
internationally,
TREATMENT
Treatment
consists of wide excision of the tumor
with post-operative irradiation. Studies have shown
that plain radiotherapy has not been so effective in
some of the cases but when used on metastatic cases
98