Liposarcoma is a malignant soft-tissue tumour derived from fat cells also known as adipocytes. In humans, they represent the commonest soft tissue neoplasm. Most of the fatty tumours are of two types- that is either lipomas or liposarcomas. They occur at every age and at almost any possible location in the body where fatty tissue is found.
Where does liposarcoma occur ?
The major locations in which liposarcomas are seen to occur are the lower limbs, then the deep abdominal (retroperitoneal) region, and also the shoulder area. The most favoured site of occurrence is in the lower limbs.
What are the clinical features of liposarcoma ?
They are often large, that is greater than 5 cm in size, and yet, keep increasing in size. The mass is gradually increasing in size. They present deep to deep fascia and can be painless or painful. Minority of liposarcomas present with late stage progression. There could be a history of a previously excised lump.
How is liposarcoma diagnosed ?
It presents as a heterogeneous and lobulated mass (resembling soap bubbles). It often displaces the muscle. It may look encapsulated but it is actually not enclosed in a capsule.
What are the variants of liposarcoma?
The main variants include :
- Well differentiated liposarcoma, wherein the tumour cells resemble their tissue of origin, the mature fat cells.
- Dedifferentiated liposarcoma, in which the tumour cells basically lose the differentiated nature of their fat cells.
- The Myxoid liposarcoma, wherein the tumour contains copious mxyoid stroma. By myxoid, we mean this tumour will have clear, mucoid substance in abundance.
- Pleomorphic liposarcoma, wherein the tumour cells are found to be pleomorphic. This is an aggressive variant.
- Well differentiated liposarcoma : This is a low grade locally aggressive liposarcoma. It is a non- metastasizing lesion. It occurs most frequently in deep soft tissue. It is the most common of all liposarcomas. It is known to be a low-grade neoplasm; one that rarely metastasizes. It also has a much lower recurrence rate (10%) than the other liposarcomas. It is seen to occur most often, either in the retroperitoneum or the limbs. The histopathology of the well differentiated liposarcoma is the presence of large, vacuolated adipocytes or fat cells with a prominent, hyperchromatic nucleus (which is a main feature of dividing cells).
- Dedifferentiated liposarcoma : This is a high grade malignant adipocytic neoplasm showing change in an earlier more benign variant or as a secondary recurrence from the well differentiated liposarcoma.
- Myxoid liposarcoma : This is an intermediate grade adipocytic neoplasm. Mxyoid stroma is the main component besides the neoplastic adipocytes.
- Pleomorphic liposarcoma : This is a high grade liposarcoma containing pleomorphic lipoblasts. It occurs in the lower extremities more than the upper extremities. It is made up of pleomorphic spindle cells, giant cells and pleomorphic lipoblasts.
How are liposarcoma treated ?
- First the tumours have to be staged. This has to be done both locally and systemically, seeing the spread of the tumour.
- Secondly, biopsy has to be done to confirm liposarcoma. For smaller lesions, excisional biopsy is recommended for particularly the superficial lesions. For larger ones, surgical removal has to be done. Transverse incisions in extremities are to be avoided.
- Surgery (with wide, adequate margins), radiotherapy, and chemotherapy are the main pillars of treatment for liposarcomas.
How does a liposarcoma behave ?
That is based on its anatomic location, its size (>5cm) and its grade (if it well differentiated, it is less aggressive and if it is poorly differentiated or de-differentiated, it is more aggressive). Liposarcoma can recur especially if the excision is inadequate. The more aggressive variants of liposarcomas do have a probability of distant metastasis, as well. The excision of the Liposarcoma tumour has to be adequate.
What is the care to be taken after the removal of a liposarcoma ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the limbs, thorax, chest, retroperitoneum, and abdomen with radiography, MRI or CT scans. Consult an Oncologist. Adjuvant therapy may be required in cases wherein excision cannot be done completely.
How to find and reach cancer specialists for liposarcoma treatment ?
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Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
