Well-Differentiated, Myxoid/Round Cell, Pleomorphic, and Dedifferentiated Subtypes
CLINICAL SUMMARY
Liposarcoma is the second most common soft tissue sarcoma after undifferentiated sarcoma, and is further subdivided into several distinctive subtypes. It can present as a low-grade or high-grade tumor, with prognosis corresponding to grade. While treatment always includes surgical excision, the use of adjuvant radiation and chemotherapy depends on the subtype, location, and grade.
DIAGNOSTIC FEATURES
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LIPOSARCOMA SUBTYPES
Well-Differentiated Liposarcoma
Well-differentiated liposarcoma is a slow-growing lipomatous tumor that never metastasizes but can recur locally, sometimes repeatedly. It is the most common variant, making up 40% to 45% of liposarcomas.
Despite the similarity in appearance between lipomas and well-differentiated liposarcomas, the two tumors can be distinguished with careful evaluation of the MRI imaging. In particular, only 4% to 9% of well-differentiated liposarcomas show thin septa, whereas the majority demonstrates thick septa or nodular nonlipomatous components.
In the retroperitoneum, any lipomatous tumor should be considered a liposarcoma. In contrast to liposarcomas in the extremity, retroperitoneal well-differentiated liposarcomas can cause significant mortality and even morbidity, due to repeated local recurrence. The rate of dedifferentiation in the retroperitoneum is approximately 20%, compared to less than 2% in the extremities.
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