Middle East Journal of Cancer

Rare Extrapulmonary Metastases from Thigh Myxoid Liposarcoma: Two Case Reports and Literature Review

Document Type : Case Report(s)

Authors

Engy Elemry 1
Khalid Atallah 2
Ahmed Hassan 2
Ahmed Sameh 2
Shaimaa M Yussif 3
Mohamed Elhawary 4
Shadi Awny 2
Mohammad Zuhdy 2, 5

1 Mansoura University Hospital, Mansoura, Egypt

2 Surgical Oncology Department, Oncology Center Mansoura University, Mansoura, Egypt

3 Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

4 Department of Diagnostic and Interventional Radiology, Mansoura University Hospitals, Mansoura, Egypt

5 Surgical Oncology Department, King Abdullah Medical City the Holy Capital, Makkah, Kingdom of Saudi Arabia

https://doi.org/10.30476/mejc.2026.107131.2283
Abstract
Liposarcoma (LPS) is one of the most common extremity soft tissue sarcoma types arising from adipose tissue. About one-third of patients with primary localized extremity soft tissue sarcomas will develop metastatic disease during follow-up, most frequently in the lungs. Myxoid LPS (MLS) roughly represents 20%-30% of all LPSs. Unfortunately, about 10% of patients with MLS present with metastasis of the tumor in unusual sites, such as the thorax and retroperitoneum.
In the present case report, we present two cases with thigh soft tissue sarcomas metastasizing to rare sites; one to the breast and the other to the soft tissue of the neck. Their clinical presentation, radiologic, and histopathologic evaluation, in addition to their management plans, are reported in detail.
Extrapulmonary metastasis from MLS represents a diagnostic dilemma. Although multimodality approaches, including surgery, radiotherapy, and chemotherapy, are used for managing MLS, a case-by-case approach is still recommended to achieve the most favorable outcomes.

Highlights

Mohammad Zuhdy (google scholar)

Keywords

Sarcoma
Neoplasm
Metastasis
Surgery
Case report
Subjects

Please cite this article as:

Elemry E, Atallah K, Hassan A, Sameh A, Yussif SM, Elhawary M, et al. Rare extrapulmonary metastases from thigh myxoid liposarcoma: two case reports and literature review. Middle East J Cancer. 2026;17(4):372-8. doi: 10.30476/mejc.2026.107131.2283.

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. doi: 10.3322/caac.21708. PMID: 35020204.
  2. Smolle MA, Leithner A, Bernhardt GA. Abdominal metastases of primary extremity soft tissue sarcoma: A systematic review. World J Clin Oncol. 2020;11(2):74-82. doi: 10.5306/wjco.v11.i2.74. PMID: 32133276; PMCID: PMC7046921.
  3. Posch F, Leitner L, Bergovec M, Bezan A, Stotz M, Gerger A, et al. Can multistate modeling of local recurrence, distant metastasis, and death improve the prediction of outcome in patients with soft tissue sarcomas? Clin Orthop Relat Res. 2017;475(5):1427-35. doi: 10.1007/s11999-017-5232-x. PMID: 28083752; PMCID: PMC5384928.
  4. Kim DW, Jee YS. Solitary metastasis of myxoid liposarcoma from the thigh to intraperitoneum: a case report. World J Surg Oncol. 2019;17(1):172. doi: 10.1186/s12957-019-1724-3. PMID: 31660994; PMCID: PMC6819342.
  5. Sbaraglia M, Bellan E, Dei Tos AP. The 2020 WHO classification of soft tissue tumours: news and perspectives. Pathologica. 2020;113(2):70. doi: 10.32074/1591-951x-213. PMCID: PMC8167394.
  6. Tfayli Y, Baydoun A, Naja AS, Saghieh S. Management of myxoid liposarcoma of the extremity. Oncol Lett. 2021;22(2):596. doi: 10.3892/ol.2021.12857. PMID: 34188698; PMCID: PMC8228380.
  7. Saifuddin A, Andrei V, Rajakulasingam R, Oliveira I, Seddon B. Magnetic resonance imaging of trunk and extremity myxoid liposarcoma: diagnosis, staging, and response to treatment. Skeletal Radiol. 2021;50(10):1963-80. doi: 10.1007/s00256-021-03769-w. PMID: 33792747.
  8. Muhsen BA, Ghzawi A, Fares AS, Al-Hussaini M, Salah S. Metastatic myxoid liposarcoma of the brain: a case report and review of the literature. Future Sci OA. 2021;7(10):FSO756. doi: 10.2144/fsoa-2021-0077. PMID: 34840813; PMCID: PMC8610000.
  9. Homsy P, Böhling T, Seitsonen A, Sampo M, Tukiainen E, Blomqvist C. Patterns of metastatic recurrence of genetically confirmed myxoid liposarcoma. Ann Surg Oncol. 2023;30(7):4489-97. doi: 10.1245/s10434-023-13312-x. PMID: 36907960.
  10. Shinoda Y, Kobayashi E, Kobayashi H, Mori T, Asano N, Nakayama R, et al. Prognostic factors of metastatic myxoid liposarcoma. BMC Cancer. 2020;20(1):883. doi: 10.1186/s12885-020-07384-1. PMID: 32928160; PMCID: PMC7491192.
  11. Muratori F, Bettini L, Frenos F, Mondanelli N, Greto D, Livi L, et al. Myxoid liposarcoma: prognostic factors and metastatic pattern in a series of 148 patients treated at a single institution. Int J Surg Oncol. 2018;2018(1):8928706. doi: 1155/2018/8928706. PMID: 29977616.
  12. Dürr HR, Rauh J, Baur-Melnyk A, Knösel T, Lindner L, Roeder F, et al. Myxoid liposarcoma: local relapse and metastatic pattern in 43 patients. BMC Cancer. 2018;18(1):304. doi: 1186/s12885-018-4226-8. PMID: 29558901.
  13. Tran TL, Tsai I, Choi HW. Solitary metastasis to the breast from thigh myxoid liposarcoma. 2023;15(9):e45559. doi: 10.7759/cureus.45559. PMID: 37868406; PMCID: PMC10586712.
  14. Lee SJ, Ryu JK, Won KY, Han SA. Myxoid liposarcoma of the breast mimicking phyllodes tumor: A case report. J Korean Soc Radiol. 2023;84(4):952-7. doi: 10.3348/jksr.2022.0146. PMID: 37559820; PMCID: PMC10407076.
  15. Mouden K, Souadka A, Khmou M, Semmar A, Kacemi HE. Isolated Subcutaneous Metastasis of Myxoid Liposarcoma: A Case Report. J Clin Case Rep. 2016;6(894):2. doi: 4172/2165-7920.1000894.
  16. Ahmadi MS, Sheida F, Ameri A, Javadinia SA, Farahani F, Soltaninia O, et al. Ewing's sarcoma of mandible: Practical approach to a challenging case. Case Rep Oncol. 2022;15(3):927-35. doi: 10.1159/000525608. PMID: 36636676; PMCID: PMC9830304.
  17. Ariamanesh M, Tafrishi R, Dehghani M, Bakhshai M, Javadinia SA, Hosseini SM, et al. Ten years of battle with multiple recurrences of pediatric skull base chondrosarcoma: A case report. Clin Case Rep. 2021;9(10):e04904. doi: 10.1002/ccr3.4904. PMID: 34631087; PMCID: PMC8489503.
  18. Foroughi A, Arefpour AM, Nikoofar A, Sanei M, Mahdavi SH, Javadinia SA. Total neoadjuvant vs. standard perioperative cisplatin/ doxorubicin chemotherapy in patients with extremities osteosarcoma: A multi-center cohort study. Asian Pac J Cancer Prev. 2023;24(7):2369-74. doi: 10.31557/APJCP.2023.24.7.2369. PMID: 37505768; PMCID: PMC10676487.
  19. Coelho PB, Costa PA, Espejo Freire AP, Kwon D, Jonczak E, D'Amato GZ, et al. Outcomes of metastatic synovial sarcoma with doxorubicin, pazopanib, and ifosfamide therapy. J Clin Oncol. 2021;39(15_suppl):e23552. doi: 1200/JCO.2021.39.15_suppl.e23552.
  20. Vincenzi B, Olimpieri PP, Celant S, Mazzocca A, Cortellini A, Comandone A, et al. Pazopanib in the real-world setting in soft tissue sarcomas: data from the Italian national registry. ESMO Open. 2024;9(12):103995. doi: 10.1016/j.esmoop.2024.103995. PMID: 39608303; PMCID: PMC11635658.

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