Liposarcoma, a rare type of cancer, develops in fatty tissue in the limbs (especially the thigh) or abdomen but can appear anywhere in the body.
When facing a liposarcoma diagnosis, you want to be seen by health care providers who are not only highly trained and skilled, but also who see you as an individual with unique needs. That’s AHN. Our oncologists, surgeons, and other health care providers who work with liposarcoma patients have a deep understanding of the intricacies of the disease. We offer the treatments necessary to avoid bigger, more complex surgeries. Our Cancer Center also provides comprehensive palliative care to help manage side effects that occur throughout treatment.
Liposarcoma is a rare type of cancer that develops in fat cells. It's a type of soft tissue sarcoma, meaning it arises from the connective tissues of the body, including fat, muscle, blood vessels, deep skin tissues, and cartilage.
Liposarcoma accounts for roughly 0.1% to 0.2% of all cancers diagnosed annually. This makes it a relatively uncommon cancer type. It is one of the more common types of soft tissue sarcoma, but still, soft tissue sarcomas are relatively uncommon cancers overall. Approximately 20% of soft tissue sarcomas are liposarcomas. In the United States, the American Cancer Society estimates that about 13,400 soft tissue sarcomas are diagnosed annually on average. It is estimated approximately 2,680 people would be diagnosed with liposarcoma this year.
AHN Sarcoma Center of Excellence
The AHN Sarcoma Center of Excellence is made up of a team of multiple health care experts walking you through every step of your cancer diagnosis and treatment. With thorough and compassionate care, we provide treatment plans that fit your specific needs. While our care options will vary for your specific diagnosis, you can expect a treatment plan that will be tailored to you.
Diagnosis and treatment will usually begin with an appointment with our orthopaedic oncology team. The team works closely with providers amongst different medical specialties including:
- Surgeons
- Medical oncology
- Radiation oncology
- Pathology
- Physical therapy
- Occupational therapy
- Plastic surgery
- Nurse Navigators
At AHN, we strive to make your treatment course as painless as possible. We will take care of appointment scheduling, imaging planning, and other aspects of care coordination for our patients so you have time to focus on healing and recovery.
Liposarcoma symptoms and signs
Liposarcoma symptoms can be subtle, especially in early stages. The most common sign is a painless lump or swelling in the soft tissues, often in the thigh or abdomen. As the tumor grows, it may cause pain, weakness, or a feeling of fullness in the affected area. If the tumor is in the abdomen, it can lead to abdominal pain, swelling, or changes in bowel habits. Because symptoms can be hard to spot, it is important to see your doctor if you notice any new or unusual lumps or pain.
Causes and risk factors
The exact cause of liposarcoma is often unknown, but certain factors may increase your risk. Older age is associated with an increased risk. Some genetic syndromes can also increase the risk of developing soft tissue sarcomas, including liposarcoma. Prior radiation therapy for other cancers has also been linked to an increased risk. While these risk factors exist, it's important to remember that many people with liposarcoma have no known risk factors.
Liposarcoma screening and diagnosis
There are no routine screening tests for liposarcoma in the general population. Your doctor will examine the lump and ask about your medical history.
Imaging tests
Imaging tests play a crucial role in the diagnosis, staging, treatment planning, and follow-up care of liposarcoma. They help visualize the tumor, determine its size and location, assess its relationship to surrounding structures, and detect any spread to other parts of the body.
- X-Rays: May be used initially, especially if the liposarcoma is in a bone or near one. X-rays aren't the most effective for soft tissue imaging, but can identify bone involvement or displacement due to a large soft tissue mass.
- MRI (Magnetic Resonance Imaging): This is often the best imaging test for soft tissue tumors. It provides detailed images of the tumor and surrounding tissues.
- CT scan (Computed Tomography): Can be used, particularly for retroperitoneal tumors, to assess the extent of the tumor and look for spread to other organs.
- Ultrasound: May be used as an initial imaging test, especially for superficial lumps.
Biopsy
This is the only way to confirm a diagnosis of liposarcoma. AHN radiologists perform the procedure to collect a small sample of tissue from the tumor, which will then be examined under a microscope by a pathologist.
Types of biopsies:
- Needle biopsy: A needle is used to extract a small sample.
- Incisional biopsy: A small cut is made to remove a piece of the tumor.
- Excisional biopsy: The entire tumor is removed (usually if it's small and easily accessible). This can sometimes be both diagnostic and therapeutic.
- Pathology review: It's highly recommended to have your biopsy reviewed by a pathologist who specializes in sarcomas. These are rare tumors, and specialized expertise is crucial for accurate diagnosis and grading.
Types and stages of liposarcoma
Liposarcomas are classified into several subtypes based on their appearance under a microscope. The main types include:
- Well-differentiated liposarcoma: This is the most common type. It tends to be slow-growing and less likely to spread. A subtype of this is called "atypical lipomatous tumor" (ALT) when it occurs in the limbs.
- Dedifferentiated liposarcoma: This type starts as a well-differentiated liposarcoma but transforms into a more aggressive form. It is more likely to spread than well-differentiated liposarcoma.
- Myxoid liposarcoma: This type is characterized by a gelatinous appearance. It often responds well to radiation therapy.
- Round cell liposarcoma: This is a more aggressive subtype of myxoid liposarcoma.
- Pleomorphic liposarcoma: This is a rare and aggressive type of liposarcoma.
Similar to other cancers, the type and staging of liposarcoma will determine the treatment you receive. Liposarcoma is staged using the JCC (American Joint Committee on Cancer) TNM staging system. This system considers three key factors:
- T (Tumor): Describes the size and extent of the primary tumor.
- N (Nodes): Indicates whether the cancer has spread to nearby lymph nodes.
- M (Metastasis): Indicates whether the cancer has spread (metastasized) to distant sites, such as the lungs or other organs.
The cancer is then staged as I, II, III, or IV using the staging system to help and guide treatment.
- Stage I Liposarcoma: This is the earliest stage. The tumor is low-grade and either small or large but hasn't spread to lymph nodes or distant sites. Generally, the prognosis is very good and surgery may be an option to remove the tumor. Radiation therapy may be considered, especially if the tumor was large or difficult to remove completely.
- Stage II Liposarcoma: This stage involves a high-grade tumor that is either small or large, but still hasn't spread to lymph nodes or distant sites. Surgery is still the primary treatment. Radiation therapy is often recommended after surgery to reduce the risk of recurrence. In some cases, chemotherapy might be considered, particularly for larger tumors or those with aggressive features.
- Stage III Liposarcoma: The tumor can be any size or grade, but it has spread to nearby (regional) lymph nodes. There is no distant metastasis. Treatment usually involves a combination of surgery (to remove the primary tumor and affected lymph nodes), radiation therapy, and possibly chemotherapy.
- Stage IV Liposarcoma: The tumor can be any size, and grade, and may or may not have spread to lymph nodes, but it has spread to distant sites (such as the lungs, liver, or other bones). Treatment is often aimed at controlling the growth of the cancer and managing symptoms (palliative care). Options may include surgery (to remove or debulk tumors), radiation therapy, chemotherapy, and targeted therapies (if available based on specific tumor characteristics).
Liposarcoma treatment
Treatment for liposarcoma depends on the type, location, size, grade, and stage of the tumor, as well as the patient's overall health. Common treatment options include:
Surgery
The primary treatment for most liposarcomas is surgical removal of the tumor. The goal is to remove the entire tumor with a margin of healthy tissue around it (wide excision). Types of surgical approaches include:
- Wide local excision: The primary goal is to surgically remove the tumor with a margin of normal tissue around it. This "wide margin" helps to ensure that all cancer cells are removed and reduces the risk of recurrence.
- Limb-sparing surgery: When possible (especially in the limbs), surgeons try to preserve the limb's function. This might involve reconstruction with skin grafts, muscle flaps, or other techniques.
- Amputation: In rare cases, when the tumor is very large, involves critical structures, or cannot be completely removed with limb-sparing surgery, amputation may be necessary.
- Debulking surgery: For tumors in the abdomen or retroperitoneum that can't be completely removed, surgery to remove as much of the tumor as possible (debulking) may be performed. This can help improve symptoms and the effectiveness of other treatments.
Radiation therapy
Radiation therapy uses high-energy rays to kill cancer cells. It may be used as the primary treatment or before or after surgery.
- External Beam Radiation Therapy (EBRT): High-energy X-rays are delivered from a machine outside the body to target the tumor.
- Intensity-Modulated Radiation Therapy (IMRT): A more advanced form of EBRT that allows for more precise targeting of the tumor and sparing of surrounding healthy tissues.
- Brachytherapy (Internal Radiation): Radioactive sources are placed directly into or near the tumor. This can deliver a high dose of radiation to the tumor while minimizing exposure to surrounding tissues.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. It is not typically used for low-grade liposarcomas. It is used more commonly for high-grade liposarcomas, especially if the cancer has spread to other parts of the body (metastatic disease).
Targeted therapy
These drugs target specific molecules involved in cancer cell growth and survival. Some targeted therapies have shown promise in treating certain types of liposarcoma. Examples include:
- MDM2 inhibitors (e.g., milademetan): For well-differentiated and dedifferentiated liposarcomas that have MDM2 amplification. These drugs block the MDM2 protein, which normally inhibits the tumor suppressor protein p53.
- Other targeted therapies: Research is ongoing to identify other targeted therapies that may be effective against liposarcoma, based on the specific genetic and molecular characteristics of the tumor.
Liposarcoma FAQs
A liposarcoma diagnosis or being more at-risk for developing liposarcoma can bring about questions. Your AHN Care Team is here to help and talk through your concerns or questions. If you need a place to start, these frequently asked questions can aid in getting ready to speak with your health care provider.
What is the survival rate for liposarcoma?
Survival rates vary greatly depending on the stage, grade, and type of liposarcoma, as well as the patient's overall health. Generally, early-stage, low-grade liposarcomas have a good prognosis, while advanced or high-grade tumors have lower survival rates. It is best to discuss your specific situation with your doctor for personalized information.
What is the most common site for liposarcoma?
Liposarcomas most commonly develop in the deep soft tissues of the thigh. They can also occur in other areas like the abdomen and less frequently in the arms.
What are the four types of liposarcomas?
The four main subtypes are: Well-differentiated, Dedifferentiated, Myxoid, and Pleomorphic. Each type has different characteristics and behavior, which influence treatment and prognosis.
How quickly does liposarcoma spread?
The rate of spread varies depending on the subtype and grade of the liposarcoma. Low-grade liposarcomas tend to grow slowly and are less likely to spread, while high-grade liposarcomas can grow and spread more quickly to other parts of the body.
Contact us
To make an appointment you can:
- Call our scheduler: (412) 359-8614
- Schedule online
- Use MyChart and schedule with Dr. Lisa Ercolano to make an appointment
Please bring all relevant imaging on CD or through PowerShare with correlating reports for review by our team to your initial appointment.
MyChart® is a registered trademark of Epic Systems Corporation and used with permission.