Unusual biological behaviour of femoral liposarcoma

Abstract

INTRODUCTION: Liposarcoma of a bone is a very rare tumour of the fatty marrow, originating from lipoblasts. Its frequency is 1:1000 of all bone tumours. The long bones and the lower extremities are predominantly affected, equally in males and females between 30 and 70 years of age. In the estimation of its biological behaviour, histological graduation (G), the surgical localization of the tumour (T) and the presence or absence of metastases (M), are very important. A tumour with low grade differentiation, with transosseal propagation and metastases, has a poor prognosis. Surgical resection-amputation, chemotherapy and radiotherapy are the therapeutic methods of choice. CASE OUTLINE: Twelve years ago, in a 58-year old man, there was a radiologically diagnosed sarcoma in the lower part of the right femur manifested with painful swelling in that region. The high suprapatellar amputation was done. There was a histologically proved liposarcoma of a high grade of malignancy. According to the therapeutic protocol, chemotherapy and radiotherapy were applied. During the period of 12 years, the patient had a relapse on the stump, metastatic dissemination in the soft tissue of small pelvis twice, once in the left scapular region and in the inguinal lymph nodes, six operations and 8-year accumulation of metastatic deposits in the lung. Now, the patient feels relatively well, mobile, and walks 5 kilometres every day. CONCLUSION: Unusual behaviour of the liposarcoma of high grade malignancy with which the patient has been living for 12 years, could be explained by the patient's strong immunobiological system in the struggle to retain its vitality and mobility.