Primary endobronchial liposarcoma successfully resected via bronchoscopy: A rare case report with genetic analysis

Liposarcoma is the most common type of soft-tissue sarcoma, and predominantly originates from the extremities and retroperitoneal cavity. However, primary endobronchial liposarcoma is extremely rare. The present study reports on the case of a 54-year-old man, a smoker, diagnosed with primary endobronchial atypical lipomatous tumor/well-differentiated liposarcoma (ALT-WDLS), which was successfully resected via bronchoscopy. Chest computed tomography (CT) revealed a neoplasm in the left main bronchus measuring 12.8x7.8 mm. Bronchoscopy demonstrated multiple roundish, pedunculated, polypoid masses in the left main bronchus. Bioptic specimens were obtained from the roundish masses, and pathological examination revealed an adipose tissue-derived tumor. The masses were completely resected during the second bronchoscopy under general anesthesia. Histopathological examination of the radical resection specimen revealed that it was an ALT-WDLS. The patient showed good quality of life at the 6-month postoperative follow-up without evidence of recurrence. Immunohistochemistry was completed with the human homologue of murine double-minute type 2 (MDM2) (+), cyclin-dependent kinase 4 (CDK4) (+), p16 (+), S-100 (+), Ki-67 (+), cluster of differentiation 34 (CD34) (+) and retinoblastoma protein (+), confirming ALT-WDLS. However, the fluorescence in situ hybridization assay revealed no amplification of MDM2 and CDK4 in the ALT-WDLS. To the best of our knowledge, the present case report is the first to describe the clinicopathologic features and genetic analysis of endobronchial liposarcoma. Although rare, this case is a reminder that clinicians should consider the possibility of this rare endobronchial tumor in patients with nonspecific symptoms including chronic cough, chest pain and recurrent pneumonia. As in this case, endoscopic treatment provided an excellent clinical outcome in patients with primary endobronchial ALT-WDLS.