Well-Differentiated, Myxoid/Round Cell, Pleomorphic, and Dedifferentiated Subtypes
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.
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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