Liposarcoma

What is liposarcoma?

Liposarcoma is a group of very rare cancers that begin in your fat cells. You can develop a liposarcoma in any part of your body, but these tumors typically begin in your belly, arms and legs. Healthcare providers treat liposarcoma with surgery to remove tumors. Some types of liposarcoma may come back, requiring additional treatment and long-term follow up to catch new liposarcomas before they can spread.

How does a liposarcoma affect my body?

That depends on what kind of liposarcoma you have. In general, liposarcomas develop in your arms or legs, particularly in your thighs or the back of your knees, but you can also develop liposarcoma in the back of your belly.

Most liposarcomas grow very slowly and rarely cause pain. You may not notice any changes in your body unless you notice a large bump on your arm or leg that doesn’t go away or gets larger. A liposarcoma may cause pain if it presses on a nerve. Likewise, a liposarcoma may affect some of your organs. For example, a liposarcoma in your lungs may make it hard for you to breathe.

How common is this condition?

Liposarcoma isn’t common. It’s a rare form of soft tissue sarcoma, which affects approximately 4 in 100,000 people in the U.S. each year. Liposarcoma affects 1 in 100,000 people in the U.S. each year.

Who does this condition affect?

Liposarcoma typically affects more men and people assigned male at birth (AMAB) than women and people assigned female at birth (AFAB). It’s often found in men and people AMAB between ages 50 and 65, but one type of liposarcoma affects people ages 35 to 55.

Is liposarcoma an aggressive cancer?

There’s a wide range of liposarcomas. Some, such as well-differentiated liposarcoma or atypical lipoma of the extremities (arms and legs), grow slowly and aren’t life-threatening. Other types, such as myxoid liposarcoma or dedifferentiated liposarcoma, are likely to spread or come back after treatment. A pleomorphic liposarcoma can be very aggressive, growing very fast and quickly spreading from where it started to other areas of your body.

What are the types of liposarcoma?

There are several liposarcoma types. The types have similar symptoms but can require different treatments and have different prognoses or expected outcomes.

Well-differentiated liposarcoma (WDLS)

This is the most common type, accounting for 30% to 50% of all liposarcomas. These are slow-growing painless tumors. They may appear in your arms and legs or your trunk. Providers may call them atypical lipomatous tumors. When you have a liposarcoma in the back of your abdomen/belly (retroperitoneum), it’s called a well-differentiated liposarcoma.

Myxoid liposarcoma/round cell liposarcoma

These are the second most common types of liposarcoma, accounting for about 30% of all liposarcomas. Unlike other types, myxoid liposarcoma may affect people age 35 to 55. Tumors in this type of liposarcoma usually develop in people’s legs. It can spread to nearby soft tissue, including muscle and skin. You can also have this liposarcoma type in your bones, such as your pelvic bones or your spine, or organs such as your heart, lungs or your esophagus.

The term “round cell” refers to how tumor cells appear when viewed under a microscope. Round cell liposarcomas account for more than 5% of liposarcomas and are an aggressive form of liposarcoma.

Dedifferentiated liposarcoma (DDLS)

Some people with WDLS develop dedifferentiated liposarcoma. Unlike WDLS, this is usually a fast-growing tumor. DDLS typically appears in the back of people’s bellies, but may also affect their arms and legs. Like WDLS, providers treat DDLS with surgery. DDLS often come back after surgery. Overall, 44% of people with this condition were alive five years after diagnosis.

Pleomorphic liposarcoma

Pleomorphic liposarcoma is the least common form, accounting for 5% to 10% of all liposarcomas. It usually appears in people’s arms and legs, but can start in the back of their bellies or chest wall. Pleomorphic liposarcoma grows very fast, often spreading to people’s lungs. This type of liposarcoma has the worst survival rate.

What are liposarcoma symptoms?

Liposarcoma symptoms vary based on tumor size and location. Some people don’t have symptoms, but others notice unusual lumps or bumps under their skin. People often notice changes only after tumors are large enough to press on organs, such as their lungs, intestines or stomach. Symptoms may include:

• A new or growing lump beneath your skin, especially around or behind your knees or on your thighs. Any lump that measures 5 centimeters or more — about the size of the golf ball — is a symptom you should discuss with a healthcare provider.
• Pain or swelling, particularly a swollen belly.
• Weakness in the arm or leg that has the lump.
• Feeling full soon after you start eating.
• Loss of appetite.
• Constipation.
• Poop that has blood or looks black or tarry.
• Cramping.
• Bloody vomit.
• Trouble breathing.

What does a liposarcoma feel like?

It may feel like a soft or rubbery lump under your skin. You may be able to move the lump by pushing on it with your fingers.

What causes liposarcoma?

Liposarcoma happens when certain genes mutate, or change, causing fat cells to multiply uncontrollably and form tumors. Medical researchers have identified at least 20 different genetic mutations that cause liposarcoma. They don’t know all the reasons why these genes mutate, but researchers have identified some risk factors that increase your risk of developing liposarcoma:

• Radiation therapy for cancer.
• Exposure to workplace chemicals such as vinyl chloride.
• Certain inherited conditions.

How do healthcare providers diagnose liposarcoma?

Providers begin a diagnosis by doing a physical examination and asking about symptoms. Tests they may use include:

• Computed tomography (CT) scan: CT scans help providers locate tumors, including how close they are to major organs, and to evaluate tumor size.
• Magnetic resonance imaging (MRI): MRI scans help providers check on nearby nerves, blood vessels and muscles that may be affected by a liposarcoma.
• Biopsy: Providers take tumor tissue samples so medical pathologists can examine tumor cells under a microscope.
• Molecular and genetic testing: These tests determine the liposarcoma type.

How is liposarcoma treated?

Liposarcoma treatment depends on the liposarcoma type, whether the cancer has spread and, if so, where it has spread. You may have a combination of more than one type of treatment for the disease. Treatments may include:

• Surgery: A surgeon removes the tumor and surrounding healthy tissue, including microscopic tumor cells.
• Radiation therapy: You may have radiation therapy to shrink the tumor before surgery, particularly if you have myxoid liposarcomas. You may also have this treatment after surgery to reduce the risk of the cancer coming back.
• Chemotherapy: Healthcare providers may use chemotherapy to treat tumors that surgery can’t remove

What are treatment side effects?

Side effects include recovering from surgery, as well as side effects from chemotherapy and radiation therapy.

What are treatment complications?

Healthcare providers typically treat liposarcoma with surgery to remove the tumor and nearby healthy tissue. Any type of surgery may have complications. Your surgeon will discuss your specific situation, but some common surgery complications may include:

• Reaction to general anesthesia.
• Blood loss.
• Surgical wounds that don’t heal.
• Infection.
• Damage to organs or tissues affected by the tumor.
• Pain that isn’t managed by pain medication.

Can I prevent liposarcoma?

Unfortunately, you may not be able to prevent liposarcoma, particularly if you have an inherited condition that increases your risk of developing the condition. You can reduce your risk of soft tissue cancers by avoiding long-term exposure to radiation and toxic chemicals such as vinyl chloride.

Is there a cure for liposarcoma?

That depends on the type of liposarcoma you have and if it’s spread. For example, if you have well-differentiated liposarcoma that hasn’t spread, your surgeon may be able to remove the entire tumor. If the tumor doesn’t come back, your provider may consider you cured.

There are several types of liposarcoma with very different prognoses. If you have this condition, your healthcare provider is your best resource for information.

What can I expect if I have this condition?

Each liposarcoma type is different, so your healthcare provider is your best resource for information about what you may expect, given your situation. In general, you may:

• Need more than one surgery to remove the tumor or to remove a tumor that’s come back.
• Need treatment in addition to or instead of surgery. Many times, surgeons successfully treat some liposarcoma by removing the tumor. But sometimes, surgery isn’t an option, which means you’ll need different treatment that may keep a tumor from spreading or growing but may not eliminate it.
• Need ongoing treatment to keep tumors from spreading.
• Need long-term follow-up. Once you’ve completed treatment, your provider will monitor your overall health and watch for any signs of new tumors. They may recommend regular follow-up appointments for at least 10 years.
• Need emotional support. Cancer can be lonely, particularly if you have a rare cancer. Ask your provider about programs and services to help you deal with the emotional impact of having a rare disease.

When should I see my healthcare provider?

Contact your healthcare provider if you have a painless lump under your skin that’s larger than 5 centimeters (approximately the size of a golf ball) or if you experience other signs and symptoms of liposarcoma. If you’ve had liposarcoma, be sure to follow any schedule of testing or appointments that your healthcare provider suggests.

I’m worried liposarcoma may come back. What can I do to prevent that?

Unfortunately, you can’t prevent liposarcoma from coming back. Often, people with cancer that might return feel anxious every time they have a follow-up appointment. (Some cancer specialists call this “scanxiety.”) If you’re feeling anxious about the future, ask your provider what you can expect based on your situation.

What questions should I ask my healthcare provider?

Liposarcoma is a rare disease. You may not know much about it. Here are some suggestions for questions you may want to ask your provider:

• What type of liposarcoma do I have?
• What type of treatment is best for the type of liposarcoma that I have?
• What is the likelihood of treatment curing the liposarcoma?
• How will treatment affect my work and daily life?
• Will my tumor come back after treatment?
• Can treatment cure the type of liposarcoma that I have?

What’s the difference between liposarcoma and lipoma?

A lipoma is a noncancerous soft tissue tumor that grows beneath your skin. Liposarcomas are cancerous soft tissue tumors that may grow in soft tissue deep inside your body. Lipomas aren’t life-threatening and oftentimes are simply observed without treatment. Liposarcomas are treated with surgery, chemotherapy and radiation therapy. Liposarcomas may be life-threatening; while lipomas are never life-threatening.

A note from Cleveland Clinic

If you have a type of liposarcoma, you have a very rare form of cancer. Many times, healthcare providers can successfully treat this condition with surgery that removes and essentially cures the cancer. But some liposarcomas come back. You may need to have regular checkups for many years after completing treatment. Ask your healthcare provider about your situation, including symptoms that may indicate you have a liposarcoma that’s come back.