Well-differentiated liposarcoma of the pancreas: morphological features and surgical management in an elderly female patient

We report a rare clinical case of a well-differentiated liposarcoma (atypical lipomatous tumor), sclerosing subtype, arising from the pancreas in an 80-year-old female patient. The tumor initially presented as a painless bulging mass in the mesogastric region and, based on imaging studies, was interpreted as a lesion of uncertain origin, possibly related to the stomach or retroperitoneal tissue. During surgical intervention, the tumor was found to originate directly from the body of the pancreas, as confirmed by macroscopic and histological examination. Histologically, the tumor was characterized by a predominant fibrous-sclerosing component with areas of atypical lipomatous tissue, which posed significant challenges for differential diagnosis. Immunohistochemical analysis revealed subtotal nuclear expression of MDM2 and CDK4, along with heterogeneous cytoplasmic and nuclear expression of p16, consistent with tumors within the spectrum of well-differentiated liposarcoma. This case highlights the exceptional rarity of liposarcomas with a primary origin in the pancreas, the diagnostic complexity of their morphological evaluation, and the importance of a comprehensive approach including immunohistochemistry. The clinical significance of this observation is underscored by the successful radical surgical treatment performed in an elderly patient.