Liposarcoma

 Liposarcoma is a cancer that arises in fat cells in soft tissue, such as that inside the thigh or in the retroperitoneum.^[1] It is a rare type of cancer that bears a resemblance to fat cells when examined under a microscope.^[2] It is typically a large, bulky tumor, and tends to have multiple smaller satellites that extend beyond the main confines of the tumor. Liposarcomas, like all sarcomas, are rare.^[3]

Liposarcoma
Micrograph of myxoid liposarcoma, H&E stain
Specialty	Dermatology, general surgery oncology
Symptoms	A growing lump of tissue under your skin Pain Swelling Weakness of the affected limb
Causes	It's not clear what causes liposarcoma. Doctors know that liposarcoma forms when a fat cell develops errors (mutations) in its genetic code. The mutations tell the cell to multiply rapidly and to go on living when other cells would die. The accumulating abnormal cells form a mass (tumor). Several types of liposarcoma exist. Some grow slowly and the cells stay in one area of the body. Other types grow very quickly and may spread to other areas of the body.

Signs and symptomsEdit

Left leg swelling caused by underlying liposarcoma

Patients usually note a deep-seated mass in their soft tissue. Only when the tumor is very large do symptoms of pain or functional disturbances occur. Retroperitoneal tumors may present themselves with signs of weight loss and emaciation and abdominal pain. These tumors may also compress the kidney or ureter, leading to kidney failure.^{[citation needed]}

DiagnosisEdit

CT image showing a lesion that proved to be a liposarcoma

The diagnosis is established by histologic examination of the tissue, i.e., biopsy or excision. Lipoblasts are often present; these are cells with an abundant clear multivacuolated cytoplasm and an eccentric darkly staining nucleus that is indented by the vacuoles.

Medical imagingEdit

Ultrasonography may not be able to distinguish a liposarcoma from a benign lipoma, and therefore, MRI is the initial imaging of choice.^[4]

Medical ultrasonography of a liposarcoma: In this case a heterogeneous mass consisting of an upper hyperechoic portion, corresponding to lipomatous matrix, and areas of hypoechogenicity corresponding to nonlipomatous components.^[5]

 

Ultrasonography of a liposarcoma mimicking a lipoma. A homogeneous hypoechoic mass presenting with the same appearance of lipoma. It was clinically distinguished as having rapid growth.^[5]

 

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MRI of myxoid liposarcoma of high grade, in left axillary region of 40 year old man. Highlighted by the white color. Horizontal section.

SubtypesEdit

Several subtypes of liposarcoma exist:

• Well-differentiated liposarcoma, synonymous with atypical lipomatous tumor—the former term is used almost exclusively for lesions in the retroperitoneum, while the latter is used for lesions arising elsewhere
• Dedifferentiated liposarcoma—well-differentiated (high-grade) liposarcoma adjacent to a more poorly differentiated tumor
• Myxoid/round cell liposarcoma
• Pleomorphic liposarcoma

Micrograph of a myxoid liposarcoma, H&E stain

 

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Micrograph of a dedifferentiated liposarcoma, H&E stain

TreatmentEdit

Treatment of liposarcoma most often consists of surgical removal of the tumor and margin, occasionally radiation, and possibly chemotherapy, as well.^[6]

PrognosisEdit

The prognosis varies depending on the site of origin, the type of cancer cell, tumor size, depth, and proximity to lymph nodes.

Five-year survival rates vary from 56 to 100% based on histological subtype.^[7]

EpidemiologyEdit

Most frequent in middle-aged and older adults (age 40 and above), liposarcomas are the second-most common of all soft-tissue sarcomas, following malignant fibrous histiocytomas. Annually, 2.5 cases occur per million population.^{[citation needed]}

Society and cultureEdit

Notable casesEdit

• Chad Brown (1961–2014), a poker player, died from liposarcoma
• Richard Feynman (1918–1988), a theoretical physicist, died following surgery to address the disease.
• Rob Ford (1969–2016), former Toronto mayor and Toronto city councillor, died of pleomorphic liposarcoma.
• Hokie Gajan (1959–2016), former running back for the New Orleans Saints and radio color commentator for the team, died from liposarcoma
• Charlie Davies (1986-), former soccer player for the Philadelphia Union of Major League Soccer
• Mark Strand (1934-2014), former US Poet Laureate and Pulitzer Prize-winner, died from liposarcoma

This article uses material from the Wikipedia article  Metasyntactic variable, which is released under the  Creative Commons Attribution-ShareAlike 3.0 Unported License.