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Connective Tissue Oncology Society |
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| 2001 CTOS Annual Meeting Posters— Surgery ATYPICAL LIPOMAS
OF THE EXTREMITIES OBJECTIVE: Atypical lipomatous tumors also known as well differentiated liposarcomas occur predominantly in middle-aged patients and often present to the orthopaedic surgeon as painless, slow-to-moderately fast growing masses in the extremities. The purpose of this study is to describe the natural history and treatment outcome of 31 patients with superficial or deep atypical lipomas of the extremities. METHODS: The records of patients treated for atypical lipomas of the extremities were reviewed. Criteria for inclusion were a diagnosis of superficial or deep atypical lipomas made by surgical pathology, as well as a minimum follow-up of one year from the time of original diagnosis. RESULTS: Thirty-one patients met the inclusion criteria for this study. There were 16 males and 15 females, with an average age of 57 years at the time of the initial presentation (range 32 to 87 years). Mean follow-up was 7 years (range 1-28.8 years). At presentation, 19 patients reported a slowly growing mass and 12 patients reported pain as the initial symptom. Twenty-five tumors occurred in the lower extremity and 6 in the upper extremity. Sixteen patients (52%) had a recurrence at an average of 4.7 years after resection (range 2 months to 10 years). Twelve (39%) patients required additional surgical procedures to treat their tumor. Dedifferentiation to high-grade liposarcoma developed in three patients (10%). These were treated with resection and radiation with or without chemotherapy, and are disease free at latest follow-up. CONCLUSION: Atypical lipomas, whether deep or superficial, have a high propensity for local recurrence and a potential for malignant dedifferentiation. These tumors thus require careful evaluation, adequate surgical treatment and close clinical follow-up extending beyond five years.
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