bims-myxlip 2026-05-17 papers

Issue of 2026–05–17
five papers selected by
Laura Mannarino, Humanitas Research

Case Rep Infect Dis. 2026 ;2026 5538208

Cryptococcal Lung Infection Simulating Metastasis in a Myxoid Liposarcoma Patient: A Case Report.

Mariko M Kawamura, Masatake Matsuoka, Hideki Ujiie, Shin Ariga, Shinichi Nakazato, Kenjiro Kato, Takayuki Hashimoto, Yoshihiro Matsuno, Tatsuya Kato, Norimasa Iwasaki.

Introduction: Myxoid liposarcoma is a soft tissue sarcoma with a high tendency for lung metastasis. Its aggressive nature necessitates accurate diagnosis and treatment planning to improve outcomes.
Case Report: A 31-year-old man presented with a three-year history of an asymptomatic, progressively enlarging mass in his right thigh. Magnetic resonance imaging indicated a soft tissue tumor within the sartorius muscle, and an incisional biopsy suggested myxoid liposarcoma. Staging computed tomography scans revealed two nodules in the right lung, leading to an initial diagnosis of Stage IV myxoid liposarcoma. Given his overall health and the presumed resectability of the lesions, the patient underwent three courses of preoperative chemotherapy with doxorubicin and ifosfamide. Follow-up imaging showed no change in the size of the tumor or lung nodules. A wide resection of the thigh tumor was performed, including part of the vastus medialis, sartorius, and gracilis muscles. Postoperatively, 65 gray (relative biological effectiveness) of proton radiation therapy was administered. Subsequently, a robot-assisted thoracoscopic right lower lobectomy and lymph node dissection were performed to resect the lung nodules. Histological examination of the lung lesions revealed necrotizing granulomas with numerous round-shaped yeasts. The special stains confirmed pulmonary cryptococcosis, ruling out metastasis and revising the tumor staging to Stage Ib. Consequently, postoperative chemotherapy was canceled, and the patient showed no recurrence over 3 years of follow-up.
Discussion: This case emphasizes the need for histopathological evaluation of lung lesions in sarcoma patients, as not only cryptococcosis but also various fungal infections can mimic metastasis, potentially altering the treatment plan and prognosis.

Keywords: case report; liposarcoma; myxoid liposarcoma; pulmonary cryptococcosis; sarcoma

DOI: https://doi.org/10.1155/crdi/5538208

Diagnostics (Basel). 2026 Apr 24. pii: 1286. [Epub ahead of print]16(9):

Multiparametric US and MRI Features of Femoral Myxoid Liposarcoma-Case Report and Literature Review.

Thomas Ferenc, Nikolina Jurjević, Andro Matković, Lea Korša, Kristian Kunjko, Ana Terezija Jerbić Radetić, Ivana Jurca, Ranko Smiljanić, Helga Sertić Milić, Vinko Vidjak.

Background/Objectives: Myxoid liposarcoma (MLS) is a malignant soft-tissue tumor and the second-most common subtype of liposarcoma, often occurring in the lower limbs of middle-aged patients. Case Presentation: A 38-year-old male patient presented to the ultrasound outpatient clinic with a large mass in the right femoral region. It has been present for 15 years and mostly stable in size. Over the last two years, it has been slowly increasing in size, more rapidly in the previous 10 months, and has started to limit his range of motion. After multiparametric ultrasound and magnetic resonance imaging evaluation, the proposed diagnosis was myxoid liposarcoma. Following imaging workup, the patient was referred to the tertiary sarcoma center, where a biopsy was performed, and pathohistological diagnosis was low-grade myxoid liposarcoma. Contrast-enhanced computed tomography (CT) evaluation of the thorax, abdomen, and pelvis showed no signs of dissemination, and CT angiography showed no signs of vessel infiltration. Plastic surgery and vascular surgery specialists performed the extirpation of the mass with the partial resection of the adjacent sartorius muscle and the complete resection of the great saphenous vein. Subsequent pathohistological analysis of the mass and local lymph nodes showed clear surgical margins and no lymphatic or vascular invasion. The patient is currently under regular surveillance by an oncology specialist and awaiting adjuvant radiotherapy. Conclusions: A multidisciplinary approach is essential in the management of patients with MLS, as it provides a tailored, individualized assessment from diagnosis through treatment to ensure the best possible outcome.

Keywords: B-flow imaging; contrast-enhanced ultrasound; liposarcoma; magnetic resonance imaging; strain elastography; ultrasound

DOI: https://doi.org/10.3390/diagnostics16091286

JAMA Oncol. 2026 May 16.

Dose Reduction of Preoperative Radiotherapy in Myxoid Liposarcoma: The Phase 2 DOREMY Nonrandomized Clinical Trial.

Jules Lansu, Judith V M G Bovée, Pètra M Braam, Aisha B Miah, Øyvind S Bruland, Elizabeth H Baldini, Astrid N Scholten, Olga Hamming-Vrieze, Jolien Heukelom, Lisette M Wiltink, Florine Foppele, Jan F Ubbels, Vincent van der Noort, Rick L Haas.

Importance: Prospective data from 2 phase 2 trials showed favorable wound complication rates and promising local control after a reduced preoperative radiotherapy dose for myxoid liposarcoma (MLS). However, long-term follow-up data are currently lacking.
Objective: To determine the efficacy and toxicity profile of a reduced preoperative radiotherapy dose in patients with MLS with long-term follow-up.
Design, Setting, and Participants: The Dose Reduction of Preoperative Radiotherapy in Myxoid Liposarcoma (DOREMY) trial is a prospective, single-group, phase 2 nonrandomized clinical trial conducted in 9 tertiary sarcoma centers in Europe and the US. Eligible patients were adults with biopsy-proven and translocation-confirmed localized MLS of the trunk or extremity who were enrolled from November 24, 2010, to May 14, 2020. Data were analyzed from January to December 2025.
Intervention: Preoperative radiotherapy to a reduced dose of 36 Gy in once-daily 2-Gy fractions followed by resection.
Main Outcomes and Measures: Long-term local recurrence-free survival, progression-free survival, disease-specific survival, overall survival, and late toxic effects.
Results: Ninety patients (mean [SD] age, 47 [13.1] years; 50 [56%] male) were included and followed up for a median (IQR) of 66.4 (48.8-87.5) months. Preoperative radiotherapy was delivered according to protocol in all patients. Surgery was not performed in 3 patients (3%) due to intercurrent metastatic disease. Local recurrence-free survival, progression-free survival, disease-specific survival, and overall survival rates at 5 years were 97.4% (95% CI, 93.9%-100%), 81.0% (95% CI, 72.6%-89.4%), 89.5% (95% CI, 82.6%-96.4%), and 88.5% (95% CI, 81.2%-95.8%), respectively. In total, 18 patients (21%) experienced a wound complication, and 14 (16%) required intervention. Any grade 2 or grade 3 late toxic effects were seen among 13 patients (15%) and 3 patients (3%), respectively.
Conclusions and relevance: This long-term analysis of the DOREMY nonrandomized clinical trial demonstrated excellent local control and a favorable toxicity profile following dose reduction of preoperative radiotherapy in patients with MLS. These compelling phase 2 findings support adoption of this regimen as an appropriate treatment option through shared decision-making with the patient, given the impracticality of conducting a phase 3 trial for a rare cancer.
Trial Registration: ClinicalTrials.gov Identifier: NCT02106312.

DOI: https://doi.org/10.1001/jamaoncol.2026.1577

Front Oncol. 2026 ;16 1820227

Prognostic value of nutritional and inflammation-based scores in advanced soft tissue sarcoma treated with trabectedin: a multicenter study.

Seda Jeral Evinç, Çağla Eyüpler Akmercan, Selin Cebeci, Zeliha Birsin, İsmail Nazlı, Ali Kaan Güren, Selver Işık, Bahadır Köylü, İlknur Deliktaş Onur, Tugay Atasever, Tuğba Kaya, Emir Çerme, Murat Günaltılı, Berrin Papila, Nebi Serkan Demirci, Çiğdem Papila, Özkan Alan.

Background: Trabectedin is a standard treatment for advanced soft tissue sarcomas (STS) after anthracycline failure. However, reliable prognostic markers remain limited. This study aims to evaluate the prognostic significance of inflammatory indices and the modified Glasgow Prognostic Score (mGPS) in STS patients treated with trabectedin.
Methods: We retrospectively analyzed 60 patients with advanced soft tissue sarcoma treated with trabectedin between 2015 and 2024 across multiple tertiary oncology centers. Baseline laboratory parameters obtained within two days prior to treatment initiation were used to calculate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), pan-immune-inflammation value (PIV), inflammatory burden index (IBI), prognostic nutritional index (PNI), and modified Glasgow Prognostic Score (mGPS). Associations with overall survival were evaluated using Cox proportional hazards regression. Skewed continuous variables were log-transformed prior to analysis. To reduce the risk of overfitting, a limited number of clinically relevant variables were included in the multivariate model, while potential collinearity among inflammatory indices was considered.
Results: A total of 37 patients (61.7%) were female, with a median age of 54.5 years (range: 35-77). Leiomyosarcoma was the predominant histological subtype, observed in 55% of cases. Trabectedin was administered at a median of the third-line setting (range: 2nd to 5th line). The objective response rate (ORR) was 24%, while the disease control rate (DCR) was 56%. The median follow-up duration was 10.2 months (range: 1-50.7). Median progression-free survival (PFS) was 4.9 months, and median overall survival (OS) was 11.7 months. Patients with mGPS 0 had significantly longer OS than those with mGPS 1 or 2 (median OS: 20.5 vs. 10.1 and 10.9 months; p = 0.006). In multivariate analysis, higher mGPS (1-2 vs 0) remained independently associated with worse OS (HR 3.9; 95% CI 1.5-10.0; p = 0.004).
Conclusion: In this multicenter real-world cohort, mGPS was identified as an independent prognostic factor for overall survival in patients with advanced soft tissue sarcoma treated with trabectedin. These findings support its potential utility for prognostic stratification, warranting further prospective validation.

Keywords: inflammatory markers; modified Glasgow prognostic score; nutrition; overall survival; prognosis; soft tissue sarcoma; trabectedin

DOI: https://doi.org/10.3389/fonc.2026.1820227