Well differentiated liposarcoma of face: An unusual case report

Background:  Liposarcoma’s are rarely reported in the head and neck region. The lacking literature evidence of this particular entity makes the clinical identification and treatment decision very challenging. Here we present a case of liposarcoma in a 95 year old female.

Method: A 95 year old patient presented to the Department of Facio-maxillary surgery with a swelling on her left cheek region. On examination, it is normal in color and texture, about 4 x 4.5 cm in maximum dimension. On palpation it is soft in consistency and non tender. Contrast enhanced computed tomography scan revealed a mass like proliferation of fat measuring 5.2x 5 x 7 cm in the left masticator space with extent into buccal cavity. It was provisionally diagnosed as Liposarcoma and excisional biopsy was carried out under general anesthesia.

Results: On histopathological evaluation, portions of a vaguely circumscribed tumour were identified which composed of mature adipocytes, of varying shapes and sizes, interspersed with spindle cells and lobulated by thin fibrovascular septa. The adipocytes and spindle cells display enlarged, hyperchromatic nuclei exhibiting irregular contours, inconspicuous nucleoli and brisk mitotic activity, with several abnormal forms. Numerous multinucleated tumour giant cells, inclusive of wreath-like forms, as well as rare, “floret-like” lipoblasts are identified. There is patchy myxoid change and focal areas of interstitial haemorrhage. Overall features were suggestive of Liposarcoma.

Conclusion: The rareity and varied presentation of liposarcoma makes it a extremely challenging case particularly in the head and neck region where management should be individually tailored based on through histological grounds.

Dr. Anu Jose practices as a Facio-Maxillary Surgeon at The University Hospital of the West Indies, Kingston, Jamaica, and as an Oral and Maxillofacial Oncologist at FOSA Surgical Associates. Dr. Jose's academic journey commenced with her comprehensive post-graduate training in OMFS at PMNM Dental College and Hospital This rigorous residency provided extensive exposure to the full spectrum of oral and maxillofacial pathology, establishing the foundation for her subsequent subspecialization. Her Fellowship in Oral Oncology from the distinguished SGM Cancer Center has equipped her with unparalleled expertise in managing complex head and neck malignancies. Her pursuit of advanced fellowship training in oral oncology reflects her dedication to mastering the most complex aspects of head and neck cancer management, positioning her among the elite practitioners in this highly specialized field.

Dr. Jose's intellectual contributions to the field are substantiated by her impressive portfolio of over 28 peer-reviewed publications in prestigious journals indexed within PubMed and Scopus databases. Her research addresses critical areas of clinical relevance, with particular emphasis on oncological outcomes, reconstructive innovations, and evidence-based surgical protocols. Dr. Jose's commitment to advancing the field through innovation is exemplified by her recent patent achievement: "A Scale for Evaluation of Asymmetry of Lip Following Lip Reconstruction in Patients with Oral Squamous Cell Carcinoma" (Registration Number L-152732/2024). This groundbreaking development addresses a critical gap in post-operative assessment protocols, providing clinicians with a standardized methodology for evaluating functional and aesthetic outcomes following complex lip reconstruction procedures.