CASE REPORTS   

Minerva Chirurgica 2010 August;65(4):479-84

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: Italian

Retroperitoneal dedifferentiated lipo-sarcoma (DDLS) with hyperglycemic activity: case report and literature review

Parmeggiani D. ¹, Avenia N. ³, De Falco M. ², Bilancio G. ², Ruggero R. ², Docimo G. ², Gubitosi A. ², Fiore A. ¹, Atelli P. ¹, Misso C. ¹, Mordente S. ¹, Parmeggiani U. ¹ ✉

¹ VI Division of General Surgery, Department of Emergency Surgery, Naples, Italy; ² Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy; ³ Unit of Endocrinological Surgery, Universitary Hospital of Terni, Terni, Italy

The authors describe a Retroperitoneal De Differentiated LipoSarcomas (DDLs), that for its clinical behavior shows peculiar characteristics and original aspects: typical is the recurrence due to local invasiveness, but absolutely original seems to be the surviving time, maybe correlated to its histological evolution (dedifferentiation from leiomyosarcoma to liposarcoma) and an interesting correlation from the tumor recurrence and the glycemic curve first and after the surgical treatments. A 66-year-old woman, presenting typically with very big abdominal masses, treated three times in almost three years, every time with aggressive surgical treatments. Histological response was leiomyo-sarcoma in the first two operations and liposarcoma in the last treatment and in every preoperative phase the patient, normally prediabetic, started to have problem of glycemia balancing, needing an insulin support until the postoperative phases when its glycemia was coming back in normal value without insulin needs, of course until a new tumor recurrence. This last aspect, not depending on pancreas involvement or hormonal activity (immune-histo-chemistry was never conforming a neuro-endocrine activity), seems probably due directly to a mass and metabolic effect of the tumor. Beginning from the description of this case and its interesting biology and reviewing most of the literature on the argument, authors hope to give our support to still debated and partially unknown aspects of these kinds of tumors.