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Liposarcoma - Medical Malpractice
Liposarcoma is a cancer of the fat cells of the body. It occurs most commonly in the thighs and in the retroperitoneal area-the area behind the abdominal contents. It is considered a soft tissue sarcoma because it has a soft consistency being made of fat cells. It often shows up as a painless, slowly enlarging and non-ulcerated mass but it can grow rapidly, being painful due to compression of surrounding tissues and ulcerating through the skin. It was first identified in the 1860s.
Most cases of liposarcoma come out of nowhere and do not arise out of an existing lipoma underneath the skin. There are five types of liposarcoma as defined by their cytology: 1) well differentiated; 2) de-differentiated; 3) round cell; 4) myxoid and 5) pleomorphic. There are three types as defined by their biology: 1) well-differentiated; 2) pleomorphic and 3) myxoid and/or round cell type.
About 5000 cases of liposarcoma occur in the US per year. Liposarcomas make up less than 20 percent of all sarcomas from soft tissue and the average person developing the disease is around 50 years old. It is very rare in children. Around the world, there are about 2.5 cases of liposarcoma per one million population and it represents 17 percent of all soft tissue sarcomas. The five year survival rate of those with high grade sarcoma is less than half of all patients. This is because it is common to have metastases, particularly in cases that are poorly differentiated. The most common sites of metastases include the liver and the lungs. If you have primary cutaneous liposarcoma (of the skin), the course is slow and indolent and you tend not to die from this condition.
There are no racial differences among those who get the disease but men get the condition slightly more commonly than females.
As mentioned, liposarcomas are more common in the extremities, especially the thigh. It is also seen in the retroperitoneal area and sometimes in the head and neck region. They tend to arise from deep fat that has a lot of vasculature and less likely from subcutaneous fat (just under the skin). Skin related liposarcomas are uncommon but, when they occur, they appear as dome-shaped lesions.
There are few symptoms of liposarcoma unless the tumour becomes large and pinches other tissues. In such cases, there can be other symptoms including referred pain if a nerve is pinched, swelling of the affected area, numbness, decreased range of motion of the affected extremity, varicose veins in the affected area, abdominal pain, fatigue, nausea, vomiting and weight loss.
On examination, the doctor will find a well circumscribed mass that can be as big as 10 centimetres in diameter. It grows slowly and is usually not tender to the touch. There can be overall abdominal pain if the liposarcoma is in the retroperitoneum. If it occurs on the skin, it appears as a dome-shaped lesion or as a skin tag, however this is uncommon. You can get unusual shapes of the liposarcoma if it is trapped within fascial planes of the leg, inguinal area or retroperitoneum. Lymph nodes can be swollen near the liposarcoma or far away, if the disease has metastasized.
A CT scan or MRI scan can show the presence of a deep liposarcoma. If it has eroded into bone, the CT scan is the better test because it can show bony erosion better. The MRI scan can show the fatty areas better than the CT scan.
There is a three stage staging system for liposarcomas. These are Stage I, II and III. Localized tumours are broken down into four separate sub stages, including IA, IB, IIA and IIB. Stage III represents metastatic disease.
Liposarcomas are treated with surgery to remove the tumour, chemotherapy and radiation therapy. The myxoid type is particularly sensitive to radiation. Different histological types of liposarcoma respond to different chemotherapeutic agents so the diagnosis under the microscope is important.LEGAL HELPLINE: ☎ 855 804 7125