Liposarcoma

What Is a Liposarcoma?

Liposarcoma is a type of soft tissue tumour that starts in fat cells.

A Liposarcoma can grow anywhere on the body, although it is commonly found in the abdomen, legs, or arms. They typically grow slowly and cause minimal symptoms. They are often identified on imaging investigations performed for other reasons.

Who Do Liposarcomas Affect?

Liposarcoma occurs equally in men and women. It is most common between the ages 50 and 70 years of age.

Liposarcoma’s account for 20% of all soft tissue sarcoma’s in adults.

Types of Liposarcoma

Liposarcoma is divided into different types depending on the characteristics of the cancer cells and how quickly they grow, these classifications are:

1. Well-differentiated liposarcoma: The most commonly diagnosed liposarcoma, with cells that grow slowly and closely resemble typical fat cells. This form is locally aggressive but is unlikely to metastasize (spread elsewhere in the body).
2. De-differentiated liposarcoma: Usually found within the abdomen (belly), but can occur in the extremities or chest area. A more aggressive form of liposarcoma that has the ability to metastasize.
3. Myxoid and Round Cell liposarcomas: Characterised based on their features on biopsy. Most commonly found in deep tissues of the extremities (usually the proximal thigh). Round cell liposarcomas are the more aggressive type.
4. Pleomorphic liposarcomas: The rarest type of Liposarcoma and the most aggressive. These have a high likelihood of returning after treatment.

Symptoms of Liposarcoma

Some people with Liposarcoma have no symptoms other than a painless mass on their extremities (arms or legs) or abdomen.

As a Lipomatous tumour grows and presses on nearby nerves, muscles, or organs, symptoms can occur. Liposarcoma symptoms differ depending on where the tumour is located.

How is a Liposarcoma Diagnosed

Doctors use a variety of tests to confirm a liposarcoma diagnosis. These tests include the following:

• Physical Exam: During a physical exam, a doctor looks at and assesses the tumour.
• Imaging Tests: Tests such as CT and MRI scans help doctors locate the tumour and determine if it is cancerous or benign.
• Biopsy: A doctor uses a needle to take a sample of tissue from the tumour. Reviewing the cell sample under a microscope can identify features of liposarcoma.

Surgical Treatment of Liposarcoma

The most common treatment for Liposarcoma is surgical removal of the tumour. This can be a challenging process, especially if your tumour is close to a vital organ. The tumour is removed with a margin on normal surrounding tissue if possible. This improves the chance of cure and reduces the risk of the tumour re-occurring.

In select cases, the treating team may recommend radiation therapy or chemotherapy before your surgery to help shrink your tumour.

Treatments After Surgery

Radiation Therapy

The use of radiotherapy for these tumours in controversial. It is used in very select cases dependant on the type of liposarcoma (myxoid) and the location. Radiotherapy is more useful in the management of metastatic disease.

Chemotherapy

Liposarcomas are resistant to most chemotherapy agents and there is no role for routine chemotherapy after surgery. Chemotherapy is reserved for when there is metastatic disease.

What are the outcomes for treatment of Liposarcoma?

Outcomes for liposarcoma vary widely depending on the pathological subtype and location of the tumour. Myxoid and Well differentiated liposarcoma’s have the best outcomes when comparing the different subtypes; as do tumours that arise in the limbs compared with those arising in the abdomen.