Question.
Based on the initial images, what is your first impression?
Based on the initial images, what is your first impression?
Immunohistochemistry:
CDK4
CDK4
MDM2
⚕️Diagnosis:
🔬Well-differentiated liposarcoma
🔬Well-differentiated liposarcoma
Question:
In adults, which of the following sarcomas is the most common in the spermatic cord?
In adults, which of the following sarcomas is the most common in the spermatic cord?
1/ In children, rhabdomyosarcomas are the most common, while in adults, liposarcoma are more likely.
2/ Lipoma (not a sarcoma😉), are the overall most common tumour in this region.
3/ Well-differentiated LPS is the most common type in this location.
sciencedirect.com/science/articl…
2/ Lipoma (not a sarcoma😉), are the overall most common tumour in this region.
3/ Well-differentiated LPS is the most common type in this location.
sciencedirect.com/science/articl…
Question:
Based on a 1998 study, how many incidental liposarcomas (LPS) where identified during hernia repair operations?
Based on a 1998 study, how many incidental liposarcomas (LPS) where identified during hernia repair operations?
3/ LPS occurring in the inguinal canal are rare and the below study (N= 1,736) found only 2 cases (less than 0.1%).
4/ LPS here can be from:
➡️Extension from a retroperitoneal LPS
➡️Primary inguinoscrotal LPS
onlinelibrary.wiley.com/doi/abs/10.100…
4/ LPS here can be from:
➡️Extension from a retroperitoneal LPS
➡️Primary inguinoscrotal LPS
onlinelibrary.wiley.com/doi/abs/10.100…
5/ This study showed that retroperitoneal LPS (RLPS) extending into the inguinal canal had a worse overall prognosis compared to an inguinoscrotal LPS.
6/ Their conclusion is searching for RLPS, in these cases, is crucial for further management.
ncbi.nlm.nih.gov/pmc/articles/P…
6/ Their conclusion is searching for RLPS, in these cases, is crucial for further management.
ncbi.nlm.nih.gov/pmc/articles/P…
Question, and change of pace!
MDM2 (with CDK4) is a useful IHC marker for well differentiated LPS.
Which of the follow is also frequently positive for MDM2?
MDM2 (with CDK4) is a useful IHC marker for well differentiated LPS.
Which of the follow is also frequently positive for MDM2?
7a/ Intimal sarcomas, thought to arise from large blood vessels or heart*, can show nuclear expression of MDM2 and MDM2 amplifications.
8/ Other tumours that can be positive by IHC, are low grade osteosarcoma & some rhabdomyosarcomas.
*see next tweet
sciencedirect.com/science/articl…
8/ Other tumours that can be positive by IHC, are low grade osteosarcoma & some rhabdomyosarcomas.
*see next tweet
sciencedirect.com/science/articl…
7b/ ⚠️Below is an interesting letter pointing out that the intimal sarcomas in the heart might be a misnomer …? Endocardial/cardiac sarcoma?⚠️
journals.lww.com/ajsp/Fulltext/…
journals.lww.com/ajsp/Fulltext/…
Last question,
What does MDM2 do?
What does MDM2 do?
9/ Murine double-minute type 2 (MDM2) is a protein that inhibits p53 (and is amplified in well-differentiated liposarcomas).
10/ Lastly, Cyclin-Dependent Kinase 4 (CDK4) inhibits retinoblastoma 1 (RB1).
journals.lww.com/ajsp/Fulltext/…
10/ Lastly, Cyclin-Dependent Kinase 4 (CDK4) inhibits retinoblastoma 1 (RB1).
journals.lww.com/ajsp/Fulltext/…
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