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Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: Importance of histological subtype with treatment recommendations

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Abstract

Background

This study defines the behavior and classification of atypical lipomatous tumors (ALT) and well-differentiated liposarcomas (WDLS) of the extremity and trunk.

Methods

A total of 91 well-differentiated lipomatous tumors of the extremity and trunk were identified from a soft tissue tumor database between July 1982 and June 2001. A soft tissue pathologist, blinded to prior diagnosis and clinical outcome, reviewed histology. Those composed predominantly of mature adipose tissue with scattered atypical stromal cells and scant lipoblasts or fibrosis were ALTs. Tumors with lipoblast but <25% fibrosis were termed lipoma-like WDLS, and those with >-25% fibrosis were identified as sclerosing WDLS. Clinical factors were analyzed to assess effects on local recurrence-free survival (LRFS).

Results

Histological review identified 34 ALTs and 57 WDLSs. Of the WDLSs, 29 were lipoma-like and 28 were sclerosing. Five-year and 10-year LRFS were 100%±0% and 78%±9%, respectively. Factors evaluated were age, sex, tumor site, tumor size, histology, presentation status, margin status, and adjuvant radiotherapy. Positive resection margins and sclerosing histology were associated with reduced LRFS. Dedifferentiation was observed in three tumors (3%)

Conclusions

Lipoma-like WDLSs and ALTs share similar histological features and favorable behavior. Margin-positive sclerosing WDLSs have a 10-year LRFS of only 17% and should undergo function-preserving re-excision when possible, or adjuvant radiotherapy.

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Authors and Affiliations

  1. Departments of Surgery, Memorial Sloan-Kettering Cancer Center, H1210, 1275 York Ave., 10021, New York, NY

    David A. Kooby MD, Murray F. Brennan MD & Samuel Singer MD

  2. Departments of Pathology, Memorial Sloan-Kettering Cancer Center, H1210, 1275 York Ave., 10021, New York, NY

    Cristina R. Antonescu MD

Authors
  1. David A. Kooby MD
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  2. Cristina R. Antonescu MD
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  3. Murray F. Brennan MD
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  4. Samuel Singer MD
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Correspondence to Samuel Singer MD.

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Kooby, D.A., Antonescu, C.R., Brennan, M.F. et al. Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: Importance of histological subtype with treatment recommendations. Annals of Surgical Oncology 11, 78–84 (2004). https://doi.org/10.1007/BF02524350

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  • DOI: https://doi.org/10.1007/BF02524350

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