Neural sheath liposarcoma

Abstract

Liposarcoma is a malignant mesenchymal tumor of the adipose tissue1. Liposarcomas most frequently arise from the deep-seated stroma rather than the submucosal or subcutaneous fat2. The most recent World Health Organization classification of soft tissue tumors recognizes five categories of liposarcomas: (1) well differentiated, which includes the adipocytic, sclerosing, and inflammatory subtypes; (2) dedifferentiated; (3) myxoid; (4) round cell; and (5) pleomorphic2-4.The anatomical distribution of liposarcoma appears to be partly related to the histologic type. Well-differentiated liposarcoma tends to occur in deep soft tissues of both the limbs and the retroperitoneum. Myxoid and/or round-cell liposarcomas and pleomorphic liposarcomas have a striking predilection for the limbs, and dedifferentiated liposarcoma occurs predominantly in the retroperitoneum4. Nerve involvement can be identified clinically with symptoms or signs of nerve compression, or by images showing direct contact of the tumor with a nerve on magnetic resonance imaging and then further defined at the time of surgery as tumor abutting (capsular involvement) or encasing a peripheral nerve5. We present a case of Liposarcoma involving the medial sural cutaneous nerve.