An 82-year-old woman presents to the emergency department because of excruciating right flank pain and fever for the past 2 days

An 82-year-old woman presents to the emergency department because of excruciating right flank pain and fever for the past 2 days. She states that she is having trouble urinating. Her past medical history is unremarkable. A urinalysis is performed and comes back positive for leukocytes and gram-negative bacilli. A contrast computed tomography of the abdomen is performed and reveals a large retroperitoneal mass compressing the right ureter, leading to hydronephrosis of the right kidney. The mass is excised. Histopathologic evaluation of the mass is shown in the image below, and it is determined to be malignant. Which of the following is the most likely diagnosis in this patient?

  • A.Liposarcoma
  • B.Lipoma
  • C. Rhabdomyosarcoma
  • D. Teratoma
  • E. Leiomyosarcoma

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Image: by Gabriele et al., License: CC BY 2.0

Explanation: This patient is presenting with symptoms that are most likely due to a mass effect associated with a tumor. The histology of this tumor shows large, immature cells filled with abundant clear cytoplasm. These cells have the characteristic appearance of adipocytes, specifically lipoblasts. (Correct answer A)