A liposarcoma is a type of fatty cancer that can be relatively benign or aggressively malignant. In its most malignant form it can metastasize to other body areas. The treatment and management of liposarcomas depend on the spread of the disease and on the grade and stage of the tumor. Liposarcomas are soft tissue tumors which can show up anywhere.

Liposarcomas are a type of soft tissue sarcoma that is relatively uncommon. Only about five thousand cases of soft tissue sarcomas occur each year in the US, which is about one percent of all cancers. Liposarcomas represent about 10-18 percent of all soft tissue sarcomas, making it the second most common type of soft tissue sarcomas.

Liposarcomas are derived from fat cells. It occurs in adults between the ages of forty and sixty years and is more common in men. The most common locations of liposarcomas are the extremities, which account for fifty percent of all liposarcomas. It shows up initially as a painless, slow growing mass. They are often noticed after some trauma to the area.

It was a type of cancer first described by R. Virchow around 1857. It has a tendency to occur in visceral places, such as in the retroperitoneum of the abdomen. This happens in a third of all cases. They tend to be discovered much later than in the extremities because it can take up a lot of space before it is noticed. It can cause bowel blockage or kidney problems as a result of pressure on these organs which makes it then identifiable to doctors.

Liposarcoma occurs in the head and neck area in about five percent of cases and the upper extremities represent ten percent of all cases. It can occur in the breast and in many other areas where fatty cells exist.

The most common complaint in a case of liposarcoma is a mass that gradually grows with time. They do not hurt unless they are traumatized. They can get very large and can range from benign lipomas, which are not technically cancerous, to aggressive liposarcomas, which need surgical treatment to remove the tumor.

The diagnosis of liposarcoma includes a history and physical examination and imaging tests with plain films, CT scan and MRI scan of the affected area. MRI is the best test for liposarcomas of the extremities and in the retroperitoneal area. The MRI scan can tell how well differentiated the tumor is so that you can see how aggressive the tumor is. An encapsulated tumor is safer than an unencapsulated tumor. Liposarcomas are lobulated and well circumscribed in general. There are thick fibrous septums within the tumor and there tends to be a lot of fibrous tissue within the expanse of the cancer.

A biopsy is the best way to diagnose a liposarcoma. The biopsy is part of the staging process, which controls the type of treatment you will receive. The liposarcoma can be high grade, medium grade or low grade. The high grade tumors are the most aggressive of all liposarcomas. The imaging studies can help in determining the stage of the tumor.

There are four subtypes of liposarcoma: well-differentiated, pleopmorphic, myxoid and undifferentiated. They are of different grades and look different under the microscope. The well-differentiated types are low grade and make up fifty percent of liposarcomas. The myxoid type is more common in children. They carry a moderate metastatic risk and are intermediate grade. The pleopmorphic form is high grade and has a high risk of metastases. The dedifferentiated form is also high grade and comes from a degeneration of the well differentiated types.

The treatment of liposarcoma is usually surgical. Surgery attempts to remove the tumor in its entirety so that it cannot recur. Amputation is not out of the question but is not necessary if the tumor can be entirely removed. Radiation is used for those cases that need it. The local control rate of liposarcomas is about 85 to 90 percent. The role of chemotherapy in the management of liposarcoma is still controversial but can be used in some isolated cases.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here