What Are the Signs and Symptoms of Liposarcoma?

There are five types of liposarcoma:

• Well-differentiated liposarcoma 
  • The most common subtype 
  • Usually starts as a low-grade tumor and tends to grow and change slowly
  • Often presents as a large painless mass found in deeper tissues and in the space behind the abdominal cavity (retroperitoneum)
• Dedifferentiated liposarcoma
  • Occurs when a low-grade tumor changes, and the newer cells are high-grade
• Myxoid liposarcoma
  • Intermediate to high-grade tumor
• Round cell liposarcoma 
  • Can grow faster than well-differentiated tumors
  • Often found in the arms or legs
• Pleomorphic liposarcoma 
  • The rarest subtype 
  • A high-grade tumor 
  • Has a high rate of recurrence and poor outcomes

The cause of liposarcoma is unknown. Liposarcomas most often occur in adults between ages 40 and 65. If it does occur in children, it is usually during the teenage years. 

Risk factors for developing liposarcoma include: 

• Certain genetic syndromes
• Exposure to radiation from treatment for another cancer
• Exposure to some chemicals
• Damaged lymph system

Liposarcoma is diagnosed with a physical examination. Tests used to help confirm the diagnosis include: 

• X-ray 
• Computed tomography (CT) 
• Magnetic resonance imaging (MRI)
• Biopsy
  • Needle biopsy
  • Surgical biopsy

Treatment for liposarcoma depends on the type, size, and location of the tumor. Treatment for liposarcoma includes: 

• Surgery
  • The main treatment for primary liposarcomas that have not yet spread to other organs
  • Involves removal of the tumor, along with a wide margin of healthy tissue around it
  • In about 5% of cases, amputation of a limb is needed to completely remove the cancer 
  • Complete surgical removal of tumors within the abdomen is difficult
• Combination of surgery and radiation therapy
  • Radiation therapy may be used before, during, or after surgery to destroy tumor cells and reduce the chance of the tumor recurring in the same location
  • The combination of surgery and radiation therapy can prevent tumor recurrence at the surgical site in about 85-90% of cases
• Chemotherapy
  • May be used in certain situations where patients have a high risk of recurrence or already have widespread disease
  • Erybulin mesylate (Halaven) targets a specific step in cell division that prevents cells from dividing and ultimately destroys tumor cells
  • Trabectedin (Yondelis) works similarly by interfering with the gene repair mechanism of tumor cells
• Investigational therapies: immunotherapy drugs 
  • Checkpoint inhibitors work by blocking specific receptors on cells and releasing a natural brake on immune cells, so they can activate and target cancer-specific cells
    • Examples of checkpoint inhibitors include ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda)
  • T cell therapy involves removing normal T cells from the body and modifying them to recognize and attack cancer cells based on specific cell markers