Introduction: A case of a 25-year-old female, who initially presented with right massive pleural effusion, treated as tuberculosis and who eventually with recurrence of pleural effusion and ascites, biopsy of the peritoneum was done revealing an undifferentiated malignant neoplasm of unknown origin, most likely liposarcoma.

Clinical Presentation: Patient initially presented with chronic cough and gradual onset of dyspnea. A chest radiographic finding of massive right pleural effusion led to her first admission. Succeeding admissions were due to abdominal distention, evident right breast mass and recurrence of pleural effusion. Patient was asthenic with decreased breath sounds on right lung field; firm and fixed mass on right breast; distended abdomen with ascites. Pleural and peritoneal AFB smear, culture and sensitivity; XPERT MTB/ RIF; Cytology, cell block and pleural biopsy; CT scan of the chest and whole abdomen; biopsy of right breast mass; biopsy of thickened peiritoneum were done. The patient was diagnosed with multiple organ failure secondary to disseminated tuberculosis with secondary bacterial intraabdominal infection s/p CTT, paracentesis, incision biopsy of right breast mass and exploratory laparotomy, enterolysis and omental biopsy (pending result).

Outcome: From the initial presentation of pleural effusion, patient eventually succumbed to death after five months due to multi-organ failure.

Significance of the study: This is a clinically relevant disease since liposarcoma usually occurs in male adults with a median age of 50 years old and with the dedifferentiated type becoming extremely aggressive in the post-metastasis course as patient usually dies of systemic tumor dissemination at a median of five months after developing the first metastasis

Recommendations: Management of these tumors requires a multidisciplinary team approach. Early identification of such sarcoma will lead to timely and cost-effective management. Further studies and identification of other similar cases should be done to determine or support the use of radiation and chemotherapy.

Keywords: liposarcoma, tuberculosis, malignant neoplasm of unknown origin

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