Retroperitoneal liposarcoma

Last revised by Joshua Yap on 20 Sep 2022

Retroperitoneal liposarcoma is a subtype of liposarcoma and is a malignant tumor of mesenchymal origin that may arise in any fat-containing region of the body. It is one of the most common primary retroperitoneal neoplasms.

Most cases occur in patients in the 5th to 7th decades of life, with no gender predilection 4.

Liposarcomas represent the most common variety of malignant retroperitoneal tumor.

There are five histological subtypes:

  • well-differentiated: ~55%, low grade
    • lipoma-like
    • inflammatory
    • sclerosing
  • myxoid: ~30%, low-to-intermediate grade
  • pleomorphic: high grade
  • round cell: high grade
  • dedifferentiated: high grade

Metastatic disease is hematogenous and the extent of metastases is related to the histological grade of the tumor.

  • varying amount of fat and soft tissue
    • from purely fat with rare thin septa (usually low-grade lesions) to a very heterogeneous mass with extensive amounts of soft tissue component (usually high-grade lesions)
  • multiple septa
  • enhancing soft tissue components
  • myxoid type:
    • T2: hyperintense myxoid gelatinous components
    • T1 C+ (Gd): delayed post-contrast enhancement

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

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Cases and figures

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