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A clinical review of 11 cases of large-sized well-differentiated liposarcomas

  • Original Article • TUMORS - LIPOSARCOMA
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Well-differentiated liposarcomas of the extremities are one of the most frequent types of malignant soft tissue tumors in adults. These tumors are typically locally aggressive and show a tendency to recurrence after surgical excision even though they do not metastasize and very rarely dedifferentiate. Its clinical presentation is generally a progressively growing mass causing aesthetic, functional, or compressive symptoms depending on the tumor’s size and localization. Several authors recommend a wide excision with free margins in order to minimize the risk of recurrence, while others report good results and a low rate of recurrence with more conservative or even marginal excision thereby avoiding complications due to surgical site morbidity. We present a retrospective study of 11 patients with a large-sized well-differentiated liposarcoma of the lower limb with a mean follow-up of 3.2 years. The mean size was 22 × 19 × 17 cm, and a marginal resection was made, respecting the affected neurovascular structures, in all cases. Only one recurrence was found and the functional results were 81.6% according to the MSTS functional scale 1 year after surgery. We believe that the marginal excision is a good alternative when the tumor is located near vascular or nerve structures, and as to our experience, it is not associated with elevated recurrences.

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References

  1. Sultan M, Burezq H, Bang RL, El-Kabany M, Eskaf W (2008) Giant gluteal lipoma-like liposarcoma: a case report. World J Surg Oncol 29(6):81. doi:10.1186/1477-7819-6-81

    Article  Google Scholar 

  2. Kubo T, Sugita T, Shimose S, Arihiro K, Ochi M (2006) Conservative surgery for well-differentiated liposarcomas of the extremities adjacent to major neurovascular structures. Surg Oncol 15(3):167–171

    Article  PubMed  Google Scholar 

  3. Dei Tos AP, Pedeutour F (2002) Atypical lipomatous tumor/well-differentiated liposarcoma. In: Fletcher CDM, Unni KK, Mertens F (eds) WHO classification of tumors. Pathology and genetics: tumors of soft tissue and bone. IARC Press, Lyon, pp 35–37

    Google Scholar 

  4. Errani C, Cocchi S, Ali N, Chehrassan M, Righi A, Gambarotti M, Macrogenis AF, Vanel D, Donati D (2016) Recurrence after marginal excision for atypical lipomatous tumors versus lipomas of the extremities. Orthopedics 39(3):e610–e614

    Article  PubMed  Google Scholar 

  5. Mavrogenis AF, Lesensky J, Romagnoli C, Alberghini M, Letson GD, Ruggieri P (2011) Atypical lipomatous tumors/well-differentiated liposarcomas: clinical outcome of 67 patients. Orthopedics 34(12):e893–e898

    Article  PubMed  Google Scholar 

  6. Kindblom LG, Angervall L, Svendsen P (1975) Liposarcoma a clinicopathologic, radiographic and prognostic study. Acta Pathol Microbiol Scand 253(Suppl):1–71

    Google Scholar 

  7. Evans HL, Soule EH, Winkelmann RK (1979) Atypical lipoma, atypical intramuscular lipoma, and well differentiated retroperitoneal liposarcoma: a reappraisal of 30 cases formerly classified as well differentiated liposarcoma. Cancer 43(2):574–584

    Article  CAS  PubMed  Google Scholar 

  8. Gerrand CH, Wunder JS, Kandel RA, O’Sullivan B, Catton CN, Bell RS, Griffin AM, Davis AM (2001) Classification of positive margins after resection of soft-tissue sarcoma of the limb predicts the risk of local recurrence. J Bone Joint Surg 83B(8):1149–1155

    Article  Google Scholar 

  9. Guerado E, Aguiar F (2006) Rectum compression by a gluteal lipoma. Lancet 368(9950):1893

    Article  PubMed  Google Scholar 

  10. Brooks JJ, Connor AM (1990) Atypical lipoma of the extremities and peripheral soft tissues with dedifferentiation: implications for management. Surg Pathol 3:169–178

    Google Scholar 

  11. Martín-Pedrosa JM, Del Blanco I, Carrera S, González-Fajardo JA, Gutiérrez V, Vaquero C (2002) Intravascular lipoma of the external iliac vein and common femoral vein. Eur J Vasc Endovasc Surg 23(5):470–472

    Article  PubMed  Google Scholar 

  12. Garrido-Gómez JA, Vizoso-Pérez ML, Linares-Palomino JP, Arrabal-Polo MA, Cárdenas-Grande E (2012) Intermittent claudication caused by a giant atypical lipoma of the thigh. J Vasc Surg 56(3):808–811

    Article  PubMed  Google Scholar 

  13. Weiss SW, Rao VK (1992) Well-differentiated liposarcoma (atypical lipoma) of deep soft tissue of the extremities, retroperitoneum, and miscellaneous sites. A follow-up study of 92 cases with analysis of the incidence of ‘dedifferentiation’. Am J Surg Pathol 16(11):1051–1058

    Article  CAS  PubMed  Google Scholar 

  14. Nagano S, Yokouchi M, Setoguchi T, Ishidou Y, Sasaki H, Shimada H, Kimoya S (2015) Differentiation of lipoma and atypical lipomatous tumor by scoring system: implication of increased vascularity on pathogenesis of liposarcoma. BMC Muskuloskelet Disord 16:36. doi:10.1186/s12891-015-0491-8

    Article  Google Scholar 

  15. Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple T (2002) Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 224(1):99–104

    Article  PubMed  Google Scholar 

  16. Galant J, Marti-Bonmati L, Saez F, Soler R, Alcala-Santaella R, Navarro M (2003) The value of fat-suppressed T2 or STIR sequences in distinguishing lipoma from well-differentiated liposarcoma. Eur Radiol 13(2):337–343

    CAS  PubMed  Google Scholar 

  17. Gaskin CM, Helms CA (2004) Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): results of MRI evaluations of 126 consecutive fatty masses. AJR Am J Roentgenol 182(3):733–739

    Article  PubMed  Google Scholar 

  18. Serpell J, Fisher C, Fish S, Thomas J (1992) The diagnosis of soft tissue tumors. Ann R Coll Surg Engl 74(4):277–280

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Ball AB, Fisher C, Pittman M, Watkins R, Westbury G (1990) Diagnosis of soft tissue tumor by Tru-cut biopsy. Br J Surg 77(7):756–758

    Article  CAS  PubMed  Google Scholar 

  20. Serpell JW, Chen RY (2007) Review of large deep lipomatous tumors. ANZ J Surg 77(7):524–529

    Article  PubMed  Google Scholar 

  21. Das Gupta TK, Chaudhuri PK (1998) Tumors of the adipose tissue. In: Das Gupta TK, Chaudhuri PK (eds) Tumors of the soft tissues, 2nd edn. Appleton and Lange, Connecticut, pp 229–264

  22. Lucas DR, Nascimento AG, Sanjay BK, Rock MG (1994) Well-differentiated liposarcoma. The Mayo clinic experience with 58 cases. Am J Clin Pathol 102(5):677–683

    Article  CAS  PubMed  Google Scholar 

  23. Bertrand MM, Carrère S, Delmond L, Mehta S, Rouanet P, Canaud L, Alric P, Quénet F (2016) Oncovascular compartmental resection for retroperitoneal soft tissue sarcoma with vascular involvement. J Vasc Surg 64(4):1033–1041

    Article  PubMed  Google Scholar 

  24. Sommerville SM, Patton JT, Luscombe JC, Mangham DC, Grimer RJ (2005) Clinical outcomes of deep atypical lipomas (well-differentiated lipoma-like liposarcomas) of the extremities. ANZ J Surg 75(9):803–806

    Article  PubMed  Google Scholar 

  25. Kooby DA, Antonescu CR, Brennan MF, Singer S (2004) Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: importance of histological subtype with treatment recommendations. Ann Surg Oncol 11(1):78–84

    Article  PubMed  Google Scholar 

  26. Bassett MD, Schuetze SM, Disteche C, Norwood TH, Swisshelm K, Chen X, Bruckner J, Conrad EU, Rubin BR (2005) Deep-seated, well differentiated lipomatous tumors of the chest wall and extremities: the role of cytogenetics in classification and prognostication. Cancer 103(2):409–416

    Article  PubMed  Google Scholar 

  27. Murphey MD, Arcara LK, Fanburg-Smith J (2005) From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics 25(3):1371–1395

    Article  PubMed  Google Scholar 

  28. Kemp MA, Hinsley DE, Gwilym SE, Giele HP, Athanasou NA, Gibbons CL (2011) Functional and oncological outcome following marginal excision of well-differentiated forearm liposarcoma with nerve involvement. J Hand Surg 36(1):94–100

    Article  Google Scholar 

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Authors and Affiliations

  1. Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040, Madrid, Spain

    Camilla Arvinius, Elías Torrecilla, Javier García-Coiradas, Roberto García-Maroto, María Puerto-Vázquez & Juan Luis Cebrián-Parra

  2. Hospital Universitario Severo Ochoa, Avenida de Orellana s/n, 28911, Leganés, Madrid, Spain

    Joaquín Beano-Collado

  3. Calle Gaztambide 60, 6B, 28015, Madrid, Spain

    Camilla Arvinius

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  1. Camilla Arvinius
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  2. Elías Torrecilla
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  3. Joaquín Beano-Collado
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  4. Javier García-Coiradas
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  7. Juan Luis Cebrián-Parra
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Correspondence to Camilla Arvinius.

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Arvinius, C., Torrecilla, E., Beano-Collado, J. et al. A clinical review of 11 cases of large-sized well-differentiated liposarcomas. Eur J Orthop Surg Traumatol 27, 837–841 (2017). https://doi.org/10.1007/s00590-017-1968-y

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  • DOI: https://doi.org/10.1007/s00590-017-1968-y

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