Giant oesophageal liposarcoma mimicking spindle cell liposarcoma and containing eosinophilic cells with rhabdomyoblastic differentiation

摘要

An-83-year-old Japanese man presenting with chest discomfort and vomiting was admitted to our hospital. Upper gastrointestinal endoscopy and radiological examinations showed a giant submucosal tumour in the thoracic oesophagus. Consecutive subtotal oesophagectomy showed a tumour with a maximum diameter of 12 cm, protruding into the oesophageal lumen. The patient remains stable and disease-free 18 months after tumour resection. The tumour was well demarcated with a glistening, gelatinous, white-yellowish cut surface. Microscopically, the tumour was primarily composed of spindle cells and mature adipocytes, sparsely intermingled with lipoblasts (figure 1A,B). Throughout most of the tumour, spindle cells had inconspicuous nuclear atypia, and showed partial immunoreactivity for CD34. The mature adipocytes and lipoblasts were positive for S-100 protein. Surprisingly, the tumour contained a considerable number of eosinophilic multinucleated giant cells (figure 2), which were observed throughout the tumour, and immunoreacted with desmin and myoglobin.