Liposarcoma
Steven S. Shen, MD, PhD
Jae Y. Ro, MD, PhD
Key Facts
Terminology
-
Malignant neoplasm showing adipocytic differentiation
Clinical Issues
-
Rare, but is most common sarcoma in paratesticular tissue in adults
-
Range: 41-87 years old (average: 63 years old)
-
Large scrotal mass
Macroscopic Features
-
Soft, homogeneous, multilobular, yellow to ivory mass
-
May mistaken for lipoma except for its large size and fibrous bands
-
Fleshy white tan to tan-gray firm areas with hemorrhage or necrosis indicating dedifferentiation
Microscopic Pathology
-
Mature adipose tissue of variable cellularity and fibrous tissue
-
Marked variation in adipocyte size and shape
-
Atypical cells with large, hyperchromatic nuclei
-
Lipoblasts with multivacuolated or univacuolated cytoplasm should be present but should be difficult to identify
Ancillary Tests
-
Positive for S100, CDK4, mdm2
Top Differential Diagnoses
-
Lipoma
-
Adenomatoid tumor
-
Sclerosing lipogranuloma
Bulky paratesticular mass with multilobulation due to fibrous bands  and golden yellow appearance suggests an adipocytic tumor. Uninvolved testis  is pushed to 1 side. |
Lipoma-like WDL shows mature adipocytes of variable size and shape with fibrous bands  and scattered atypical stromal cells  . Typical lipoblasts are not seen in this image. |
TERMINOLOGY
Synonyms
-
Atypical lipomatous tumor (ALT), well-differentiated liposarcoma (WDL)
Definitions
-
Malignant neoplasm showing adipocytic differentiation
CLINICAL ISSUES
Epidemiology
-
Incidence
-
Rare, but is most common sarcoma in paratesticular tissue in adults
-
-
Age
-
Range: 41-87 years old (average: 63 years old)
-
Presentation
-
Large scrotal mass
-
Usually involves spermatic cord, testicular tunica, or epididymis
Treatment
-
Surgical approaches
-
Surgical resection is usually curative
-
Prognosis
-
Favorable with complete excision
-
Unfavorable with dedifferentiation or metastasis
-
Local recurrence may occur
IMAGE FINDINGS
General Features
-
Large hyperechoic mass by ultrasonography
-
CT and MR are more specific as they may detect fat component
MACROSCOPIC FEATURES
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
