Liposarcoma
Synonyms: Lipomatous sarcoma
Most common STS in adults
Quick Facts
Behaviour
Malignant
Category
Soft tissue
Grade
Variable
Synonyms
Lipomatous sarcoma
Category
Soft tissue
Behaviour
Malignant
Grade
Variable
Gender
M = F
Tissue of Origin
Adipose
Epidemiology
- Most common soft tissue sarcoma in adults
- Peak incidence 40-60 years
- Arises from deep soft tissues, rarely subcutaneous
- Four main subtypes: well-differentiated, myxoid, round cell, pleomorphic
Clinical Features
- Painless mass, often large at presentation
- Rapid growth particularly in myxoid subtype
- Located in deep thigh, retroperitoneum, chest wall
Location
- Deep thigh (most common)
- Retroperitoneum
- Chest wall
- Deep Lower extremities
Imaging
- MRI shows fatty lesion with areas of enhancement
- Heterogeneous signal on T2-weighted imaging
- Well-differentiated: predominantly fatty appearance
- Myxoid/round cell: more cellular, increased enhancement
Pathology
- Mature adipocytes with lipoblasts
- Fibrous septa separating fat lobules
- Myxoid stroma in myxoid subtype
- Round cells with increased mitotic activity
Genetics
- t(12;16)(q13;p11) - CHOP gene fusion in myxoid subtype
- Supernumerary ring chromosomes in well-differentiated
Treatment
- Wide surgical excision with negative margins
- Chemotherapy for High-grade and myxoid subtypes
- Radiotherapy for High-grade or unresectable tumours
Prognosis
- Well-differentiated: excellent prognosis with surgery alone
- Myxoid: intermediate prognosis, 5-year survival 60%
- Pleomorphic: poor prognosis, aggressive behaviour
Key Points
- Most common STS in adults
- Subtype determines behaviour and prognosis
- Wide excision is mainstay of treatment
- Follow-up imaging critical for detection of recurrence
Workup - Local Imaging
MRI for local staging
Workup - Biopsy
- Core needle biopsy for diagnosis
- Assess subtype and grade
Workup - Staging
CT CAP
Follow-up Summary
- 1
Years 1–2
3–4 monthly clinical review + CXR; MRI primary site at 3 months post-op then 6-monthly
- 2
CT chest every 3–4 months for first 2 years (pulmonary metastasis is primary concern)
- 3
Years 3–5
6-monthly clinical review + CXR; CT chest 6-monthly
- 4
Years 6–10
Annual clinical review + CXR; CT chest annually
- 5
Discharge at 10 years with documented self-monitoring advice
- 6
Radiotherapy patients
monitor irradiated field for late effects at each review
Medical disclaimer
The content on Sarcopedia is for educational and informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical diagnosis or treatment. Always consult with a qualified physician regarding any health concerns or before starting any new treatment. Reliance on any information provided on this site is solely at your own risk.