How to Manage Liposarcoma

  •   Mon, Jul 24 2023
  •   By Dr Karthik K S

July 24, 2023

Sarcoma are cancer tumors arising from body tissue typically muscle and fat. All tumors needn't be cancers; but cancers necessarily arise from, or are tumors. Sarcomas can be of many tissue origins. There are several sarcomas, collectively called Soft Tissue Sarcoma (STS). Liposarcoma is a kind of cancer arising from soft tissue and has a lot of fat cells. It is aggressive in tumor biology but slow growing.

Liposarcoma is typically seen in the lower limb, however it is more common in retroperitoneum. It may present like a tumor in any part of the lower limb or as any body tumors. Retroperitoneum, means behind the “Abdomen Contents” in common parlance. It may present as an abdomen tumor. Liposarcoma can present in any organ, however less common.

Liposarcoma presents with varied symptoms depending on the site of presentation:

A developing or new bulge under the skin, particularly near or behind your knees or on your thighs. Any lump that is at least 5 centimeters in diameter, or roughly the size of a golf ball, should be discussed with a medical professional.

Pain or swelling, particularly a swollen belly

A weakened leg or arm where the lump is located

Feeling full soon after you start eating

Loss of Appetite

Constipation

Faeces that appear bloody, dark, or tarry

Cramping

Bloody vomit

Trouble breathing

During any suspicion, it has to be evaluated with imaging. Typically MRI or CT scan is the imaging done. PET scan is not done routinely. Biopsy will confirm the histological diagnosis. Excision biopsy has to be avoided at all cost unless there is any diagnostic ambiguity. The preferred type of biopsy is a core needle biopsy. Immuno Histo Chemistry (IHC) may also be required. Grading is also important. Difficult regions may need image guided biopsy like CT guided or USG guided.

Surgery is the best modality of treatment like in most tumors. Liposarcoma is very aggressive, poor prognostic and does not budge to chemotherapy and radiotherapy. Quality of surgery with complete removal and very good clearance margin determines the result of treatment. It also determines the duration of recurrence free survival. Chemotherapy is not very beneficial, Radiation may decrease the chances of local recurrence. Sometimes in advanced disease if surgical difficulty is determined preoperative radiotherapy may increase the chances of resection.

To summarize, liposarcoma is a rare cancer with varied presentation. Surgery is the treatment of choice. Like in most tumors and cancer, when in doubt consult a surgical oncologist.
By Dr Karthik K S
Dr Karthik KS, is consultant - surgical oncology, KMC Hospital, Mangaluru.
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