Perirenal Dedifferentiated Liposarcoma Excised as a Multiloculated Kidney Mass by Imaging.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Liposarcomas involving the kidney are rare, with most appearing as secondary involvement from large pararenal liposarcomas. A 77-year-old male patient presented with acute flank pain. CT scans demonstrated a large, thick-walled cystic lesion with rim calcifications "arising from the right inferior kidney." MRI revealed a 16.3 cm complex cystic mass with a pushing border against the uninvolved right lower renal pole. A primary cystic renal cell neoplasm was favored based on radiological findings. The patient underwent a right radical nephrectomy and adrenalectomy. Gross examination revealed a 15 cm well-circumscribed cystic mass abutting the renal capsule with a friable cut surface and extensive hemorrhage and necrosis. Microscopically, the tumor originated in the perirenal adipose tissue within renal fascia without direct infiltration into the renal parenchyma. The viable tumor accounted for approximately 10% of the mass. The tumor was surrounded by a compressed fibrous pseudocapsule. The viable tumor demonstrated a transition from a well-differentiated liposarcoma (15%) to a high-grade dedifferentiated liposarcoma (DDLPS; 85%). The dedifferentiated component was characterized by sheets of large pleomorphic tumor cells arranged in a haphazard pattern, with focal lipogenic differentiation. In contrast, the well-differentiated component consisted of adipocytic proliferation with

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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