Clinical outcomes of deep atypical lipomas (well‐differentiated lipoma‐like liposarcomas) of the extremities

Abstract

We believe the term atypical lipoma is appropriate for these tumours, as they appear not to have any metastatic potential, merely a propensity to recur locally. The chance of dedifferentiation is small and radiotherapy may play a role in its causation. We suggest that a simple marginal resection (shelling-out) is adequate treatment for these lesions. Radiotherapy should not be used.

Clinical outcome of deep-seated atypical lipomatous tumor of the extremities with median-term follow-up study

“…In past literatures, these recurrences have been reported to be between 40 and 67%. 3,5,6,9,13,18 In this current study, 2 out of 3 cases (67%) that underwent reoperation after recurrence demonstrated multiple recurrences, both of which were operated with marginal resection. Thus, preference for reoperation for recurrence is given to wide resection; however, because reoperation often reveals strong adhesion and makes contact with important nerves and vessels, the demerits of wide resection should also be considered.…”

“…Those who recommend marginal resections have suggested the limitations of their research in terms of their short follow-up periods, and also note that recurrence rates can increase as the follow-up period is increased in duration. 8,9 Rozental et al 6 and Macrogenesis et al 18 both report the necessity of at least 5 or 6 years follow-up, and we set the general median-term follow-up of 5 or more years as a cutoff point of our observation period. Among studies describing the clinical outcome of ALT in the extremities, our study has the longest minimum follow-up period.…”

“…Because ALT is an intermediate tumor, reports recommending a more conservative approach began to surface in the literature during the 2000s. 8,9 As a result, after 2005, our institution began to increasingly perform marginal resections. Evaluation of the surgical margin was conducted using resected specimens by two or more experienced orthopedic oncologists and pathologists at the time of surgery.…”

The Surgical Treatment for Recurrent Liposarcoma of the Hypopharynx in a Pregnant Woman

“…Postoperative radiotherapy has been shown to be efficient for the myxoid type of liposarcoma [14]. However, a study recommends avoiding radiotherapy since the radiotherapy may induce de-differentiation although the chance is rare in well-differentiated liposarcoma [15]. Chemotherapeutic intervention has been performed for liposarcoma; however there is no established chemotherapy for liposarcoma [16].…”

Surgical management of localized soft tissue tumors

“…An example is well differentiated liposarcoma (often called atypical lipomatous tumor) in the extremities and trunk wall, for which a marginal excision is the preferred primary approach. 24 The risk of recurrence is in the 30% range, and a wider resection can be planned reasonably at the time of recurrence. 25 Furthermore, because the risks of dedifferentiation and systemic spread are negligible in these tumors, function preservation is a principal goal.…”