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Overview 

What is liposarcoma?

Liposarcoma is a malignant(cancerous) tumor of adipose tissue that most often arises in the lower extremities (popliteal fossa and medial thigh) or retroperitoneum, perirenal, mesenteric region, and shoulder area. Liposarcomas arise from primitive mesenchymal tissue cells which are called lipoblast which is the main distinguishing feature of liposarcoma from lipoma. 

Liposarcomas are also called lipomatous tumors and usually slow growth and not cause any pain. Liposarcomas are metastases rare but retroperitoneal tumors tend to recur.

Who is affected by liposarcoma?

Liposarcomas occur more frequently seen in men than women. It is generally present in men between 50 to 65 years of life. It is almost never seen in children, but when it does, doctors or consultants usually diagnose it during the teenage years. It does not affect some particular ethnic groups more than others.

 

Is liposarcoma fast-growing?

Liposarcomas are malignant(cancerous) tumors also called lipomatous tumours. They usually grow slowly but do not cause any pain around the area of the lump. In some cases, they can grow very fast and cause pressure on nearby tissues or organs and feel the pain. Lipomatous tumours are similar to a common type of lump below the skin which is called lipomas.

 

How common is liposarcoma?

Liposarcoma is a soft tissue cancerous mass, affecting an average of 2000 individuals per year in the United States. It affects more common men than women, and more particularly middle-aged men ranging from 50 – 65 years of age people.

 

How does liposarcoma spread?

Occasionally liposarcoma spreads to other parts of your body so it is called malignant (cancerous). Where liposarcoma spreads depends on where the original tumor starts. Some most common areas of tumor metastasis include following the lungs, soft tissue in other parts of the body, and the liver. Liposarcoma is also known for its ability to chance regrowth after treatment.

 

Can liposarcoma cause weight gain?

Symptoms vary relying on the location of the tumour. For a patient with a tumour located on the abdomen, a common symptom is weight gain. A patient can gain body weight 10 to 20 pounds because some tumours can be very big between diameter 30 to 50 centimeters.

CAUSES & SYMPTOMS 

What causes liposarcoma?

Doctors or consultants are not known for sure what causes liposarcoma. Mutations in genes found in fat cells (adipocytes) may cause cells to grow disorderly causing a tumor. Consultants or doctors have also found an association between liposarcoma and other different factors. Prior exposure to radiation or certain chemicals like vinyl chloride (a toxic chemical compound used in making plastic bags) may cause liposarcoma in some people. In other cases, liposarcoma occurs due to hereditary abnormalities that are passed down from one generation to the next.

What are the signs and symptoms of liposarcoma?

Few people with liposarcomas have no signs and symptoms other than being able to feel a painless lump. People frequently notice these lumps after an injury, but trauma is unknown to be a direct causative effect. Signs and symptoms of liposarcoma are vary depending on the location of tumors that arise. That can include:

  • A  lump present everywhere on the body, or an existing lump that grows steady.
  • Painful swelling or numbness present in the area around your lump.
  • Bloody stool, or black or tarry stool which is an indication of blood.
  • Blood in vomit.
  • Abdominal pain or cramping
  • Abdominal swelling.
  • Feeling full quickly when eating
  • Fatigue (extreme tiredness)
  • Constipation 
  • Trouble breathing

MORPHOLOGY & TYPES

What are the gross features of liposarcomas?

The gross features of liposarcomas are non-encapsulated, well-circumscribed nodular mass diameter around 5 cm or more. The cut section shows that grey-white to yellow mass with myxoid and gelatinous mass. The retroperitoneal mass is generally larger than others.

soft tissue sarcoma
Gross of sarcoma

 

What is microscopy of liposarcoma?

The microscopy features of liposarcomas vary depending on the variable number of lipoblast which may be uni-vacuolated or multi vacuolated. According to Enzinger and Winslow divided into four types of liposarcoma;

  1. An atypical lipomatous tumor (ALT) or well-differentiated liposarcoma: It is the most common subtype of liposarcomas that resembles lipoma but it contains uni- or multi-vacuolated lipoblasts and scattered tumor cells with large hyperchromatic nuclei seen in the microscope.
  2. Myxoid liposarcoma: It is the second most common sarcoma but practically never occurs in the retroperitoneum. It is characterized by proliferating lipoblasts present in different stages of differentiation, chicken wire pattern of capillaries networks, monomorphic, fusiform, or stellate cells representing a primitive type of mesenchymal cells.
  3. Round cell liposarcoma: It is a high-grade variant of myxoid liposarcoma and is characterized by a cellular proliferation or round to oval cells with the presence of central hyperchromatic nuclei. It resembles a signet ring carcinoma.
  4. Pleomorphic liposarcoma:  It is characterized by highly cellular but poorly differentiated and anaplastic neoplasm containing numerous large tumor giant cells and bizarre lipoblasts.
liposarcoma
Source: Rosai and Ackerman’s Surgical Pathology (liposarcoma-picture)

 

What is retroperitoneal liposarcoma?

Dedifferentiated liposarcoma is generally non-lipogenic components within a well-differentiated liposarcoma. And it may also emerge in recurrent or metastatic foci and it resembles retroperitoneal neoplasm, so-called retroperitoneal liposarcoma

Is it a well-differentiated liposarcoma cancer? 

Well-differentiated liposarcoma or an atypical lipomatous tumor is the cancer of types of liposarcoma. Which is the most common type of liposarcomas and resembles lipoma but it contains uni- or multi-vacuolated lipoblasts and scattered tumor cells with large hyperchromatic nuclei seen in microscopes.

 

Are liposarcomas movable?

Liposarcomas tumors form under deep tissue, the most common sites are the intermuscular region in the buttocks, thigh area and retroperitoneum, etc so it is not possible to move.

 

What is liposarcoma mass?

Liposarcomas is a well-circumscribed but not encapsulated nodular mass diameter around 5 cm or more. It is composed of mature fat cells with varying numbers of hyperchromatic spindle cells and multi vacuolated lipoblasts.

DIAGNOSIS & TESTS


How do I know if I have liposarcoma vs lipoma?

The main distinction is that lipoma is benign (noncancerous) and liposarcomas are malignant (cancerous). Lipoma tumors form just under the skin in the subcutaneous tissues, usually in the shoulders region, neck, trunk, or arms. The mass tends to feel soft or rubbery and moves when pushing with your fingers.

 

How is liposarcoma diagnosed?

There are several tests used to confirm a diagnosis of liposarcomas. These tests include:

  • Physical exam: When your doctors observe and feel the tumor
  • Imaging tests: The imaging tests such as CT scan, MRI help to determine if it is benign or malignant (cancerous) tumors.
  • Biopsy: Doctors or consultants use a needle to take a sample of tissue from the tumor and observed microscopy and diagnose with help of their microscopy features.

 

Can liposarcoma be seen on ultrasound?

Liposarcomas can be noticed on ultrasound. One of the best ways to diagnostic imaging tests which are used to diagnose liposarcomas includes an ultrasound. In some cases, ultrasound can be utilized to help distinguish the type of liposarcomas based on the traits found on the sonogram.

 

Can an ultrasound tell the difference between liposarcoma and lipoma?

Well-differentiated, peripheral liposarcoma is usually hyperechoic and may be unnoticeable from a lipoma; regardless, Doppler ultrasonography studies reveal that liposarcomas are more vascular than a lipoma.

 

Does liposarcoma show in blood tests?

In common, blood tests are normal in sufferers with soft tissue sarcomas. Initial imaging studies are used which are depending on the location of the tumor. For Soft tissue sarcomas located in the extremities or the pelvic region, magnetic resonance imaging (MRI) is the choice for study. For Soft tissue sarcomas located in the abdomen region, a CT scan is the preferred investigation.

What kind of doctor treats liposarcoma?

If you have diagnosed with liposarcomas, you’ll be referred to a consultant or doctor who specializes in treating cancer called the oncologist.

 

What is the survival rate of liposarcoma?

Liposarcomas prognosis is reported based on subtypes of the disease. Average 5 years specific survival rates (chances of not dying from the cancer-related condition ) are as follows: 100% in well-differentiated liposarcoma, average 88% in myxoid liposarcoma, and average 56% in pleomorphic liposarcoma.

 

Is liposarcoma cancer curable?

The treatment of liposarcomas is based on their growth and subtype but mainly cured by surgery, with the goal of removing the tumor entirely and preventing its chances of recurrence by removing all of the tumor cells.

 

How long can you have sarcoma without knowing?

The median duration of symptoms from first patient-identifiable abnormality to diagnosis was averaged 4 months for bony sarcomas and 26 weeks for soft tissue sarcomas. The exception was chondrosarcomas with here patients who had a normal duration of symptoms of 44 weeks before diagnosis.

 

Can a lipoma be mistaken for liposarcoma?

Infrequently, consultants can’t explain for specific whether the lump is a lipoma or not. Lipomas can be confused with malignant (cancerous) tumor mass, called liposarcomas. Your consultant may feel it is the best way to remove it or take a biopsy so that they can be certain it is a lipoma or not.

MANAGEMENT & TREATMENT

What are the treatments for liposarcoma?

Treatment of liposarcomas depends on the type of cancer, whether it has spread or not so, where. If you have a combination of more than one type of treatment for the disorder. The types and duration of treatment vary depending on the type of cancer and whether it may be spread. There is the following treatment you are following:

  • Surgery: A doctor removes the tumor mass and a few of the surrounding healthy tissue because it reduces the recurrence of the tumor.
  • Radiation therapy: Radiologists use high-power X-rays to help decrease the risk of the tumor coming back again when surgery is undergone. Again and again, people have radiation therapy before surgery, so that the surgeon can remove less amount of tissue.
  • Chemotherapy: Anti-cancer drugs kill cancer cells all around the body. Most chemotherapy is delivered through infusion (injected into a vein) or in pill form. In some clinical cases, doctors use chemotherapy before surgery because it makes the tumor smaller. Doctors or consultants may recommend chemotherapy to kill any cancer cells left behind after surgery.
    • Newer drugs for liposarcomas: Halaven® (eribulin) and Yondelis® (trabectedin) are approved newer drugs for people who have not responded to initial treatment, have all-around liposarcomas, or who have cancers that cannot be removed by surgery.

 

What are the complications of liposarcoma?

The various complications are chances to develop when treatment of liposarcomas can occur.

  • Fatigue
  • Hair loss
  • Nausea
  • Neuropathy (damaged nerve around the cancer cells)

PREVENTION

How can you prevent liposarcoma?

In general, liposarcomas cannot be prevented. If you can reduce your risk factors of soft tissue cancers by avoiding long-term exposure to toxic chemical compounds like vinyl chloride and radiation.

 

Who is at risk of developing liposarcoma?

Most liposarcomas may occur in people without having any known risk factors. But few people do have a higher risk for liposarcomas. Include the following risks:

  • A family history of tumors
  • Exposure to radiation using a treatment for other cancers
  • Prolong time exposure to certain chemical compounds, like vinyl chloride.

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