Although previous studies have partially revealed the importance of the p53 signaling pathway, cell cycle regulators, and the RTK-RAS-PI3K pathway in soft tissue sarcomas with complex karyotypes, such as MFS, dedifferentiated liposarcoma (DDLS), LMS, and UPS7,18, a comprehensive overview of the molecular pathogenesis of these tumors, including differences among histological subtypes, has not previously been elucidated. Here, PIK3CA is linked to Marfan syndrome.