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Soft Tissue Tumors
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Reviewer: David Lucas, M.D., University of Michigan Health Systems (January 2009)
Revised: 14 June 2009, last major update June 2009
Definition
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● Benign tumor of mature adipocytes and mature smooth muscle
● First described in 1991 (AJSP 1991;15:121)
Terminology
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● Called lipoleiomyoma in uterus
● Note: myelolipoma is tumor with hematopoietic (including myeloid) elements, often in adrenal gland
Epidemiology
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● Very rare tumor of adults in abdomen, retroperitoneum or abdominal wall
Case reports
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● 34 year old woman with tumor of iliac fossa (World J Surg Oncol 2005;3:72)
● 55 year old woman with tumor presenting as inguinal hernia (Radiology Case Reports 2006, Vol 1, No 1)
Treatment and prognosis
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● Excision
● Does not recur, metastasize or transform
Gross description
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● Often 9 cm or more, completely or partially encapsulated, yellow-white
Gross images
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Large lobulated mass with thick pseudocapsule Fatty tissue with bands and nodules of firm white tissue
Micro description
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● Mature adipose tissue and mature (well differentiated) smooth muscle in short fascicles
● Variable fibrosis and inflammation
● No floret cells, no thick walled vessels, no necrosis, no mitotic figures
Micro images
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Mature fat and smooth muscle fibers
Smooth muscle fibers are SMA+ Smooth muscle fibers are desmin+
Differential Diagnoses
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● Liposarcoma with heterologous elements - has lipoblasts and atypia
● Angiomyolipoma - also thick walled vessels, HMB45+
● Low grade leiomyosarcoma infiltrating fat - adipose tissue is not part of tumor, spindle cells are atypical, has mitotic activity
End of Soft Tissue Tumors > Myolipoma
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