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Retroperitoneal liposarcoma

Dr Ian Bickle and Dr Gagandeep Singh et al.

A retroperiotoneal liposarcoma is a sub type of liposarcoma, a malignant tumour of mesenchymal origin that may arise in any fat-containing region of the body. It is one of the most common primary retroperitoneal neoplasms.²

There are five histological types:

well-differentiated : ~ 54 % : low grade
- lipoma-like
- inflammatory
- sclerosing
myxoid : ~ 31% : low to intermediate grade
pleomarphic : high grade
round cell : high grade
dedifferentiated : high grade

Metastatic disease is haematogenous and the extent of metastases is related to the histological grade of the tumour.

Radiographic features

CT

heterogenous mass
varying amount of fat and soft tissue
multiple septae
enhancing soft tissue components

MRI

myxoid : hyperintense on T2WI with delayed post-contrast enhancement

Treatment

The primary treatment option if resection if possible. However, local recurrence is common and occurs in 2/3 of patients. This is usually a sign of imcomplete resection and highlights the difficulty in discriminating liposarcomas from normal retroperitoneal fat.