Online ISSN: 2515-8260

BIOPSY IS NOT THE END, EFFICACY OF IHC AIDED DIAGNOSIS IN DETERMINING THEMODALITY OF TREATMENT IN LIPOSARCOMA

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Dr.N.Nivedha, Dr.R.Muthukumar

Abstract

INTRODUCTION Liposarcoma are malignant tumour of fatty tissue and are the malignant counterpart to benign lipoma. They are the second most common type of soft tissue sarcoma. There are 3 groups of liposarcoma well-differentiated (WDL) and dedifferentiated liposarcoma (DDL), myxoid/round cell liposarcoma, and pleomorphic liposarcoma. In all 3 groups, complete surgical resection is central in treatment aimed at cure and is based on grade. Radiation can reduce risk of local recurrence in high-grade lesions like dedifferentiated liposarcoma or minimize surgical morbidity in the myxoid/round cell liposarcoma group. Classification based on histological appearance is not always precise, especially because of the partial overlap of histological features of well-differentiated liposarcoma and Pleomorphic liposarcoma that may be better differentiated based on MDM2 expression on Immunohistochemistry. Detection of MDM2 and CDK4 amplification serves to determine the treatment modality. The differential diagnosis between well-differentiated liposarcoma and dedifferentiated liposarcoma from their morphologic counterparts is challenging. METHODOLOGY This study is a retrospective study done in post graduate medical college in Puducherry from January 2022 to august 2022. Patient who presented with soft tissue swelling over upper extremity who underwent surgery was included. 20 liposarcoma cases were taken in which 10 cases were of dedifferentiated liposarcoma, rest 10 cases were of pleomorphic liposarcoma. RESULT Out of 20 cases, 10 cases were pleomorphic liposarcoma, 5 were dedifferentiated liposarcoma and 5 well differentiated liposarcoma which was confirmed by Immunohistochemistry. Wide local excision was done in well differentiated liposarcoma, radiation therapy was given to dedifferentiated liposarcoma and pleomorphic sarcoma which subsequently showed improvement in the prognosis of patient. CONCLUSION The spectrum of pathological variations of liposarcoma directly impacts prognosis. Differentiation of subtypes of liposarcoma therefore has a high significance for prognosis and therapeutical approach. Even though the pathology is same the subtype decides the therapeutic conduct of patient. This study is emphasized that histopathological examination is not final modality but IHC is the final modality in management.

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