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Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma
Eric Walker, MD, MHA, FACR, FACHE; Catherine C. Roberts, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Atypical lipomatous tumor (ALT)
          • Well-differentiated liposarcoma (WDL)
        • Synonyms

          • Atypical lipoma, atypical lipomatous neoplasm, adipocytic liposarcoma, lipoma-like liposarcoma, sclerosing liposarcoma, spindle cell liposarcoma, inflammatory liposarcoma
        • Definitions

          • Intermediate, locally aggressive neoplasm composed predominantly of fat; no metastatic potential
          • WHO designation: ALT/WDL
          • WDL and ALT describe lesions that are identical both morphologically and karyotypically; named selected is based on location
          • WDL is now used for tumors of retroperitoneum, mediastinum, and deep pelvis
          • ALT includes tumors of extremities and superficial sites

        IMAGING

        • General Features

          • Imaging Recommendations

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Mashima E et al: Recent advancement in atypical lipomatous tumor research. Int J Mol Sci. 22(3), 2021
                                  2. Sbaraglia M et al: Atypical lipomatous tumor/ well-differentiated liposarcoma. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 36-8, 2020
                                  3. Kransdorf MJ et al: Lipomatous tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 147-70, 2014
                                  4. Bestic JM et al: Sclerosing variant of well-differentiated liposarcoma: relative prevalence and spectrum of CT and MRI features. AJR Am J Roentgenol. 201(1):154-61, 2013
                                  5. Brisson M et al: MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification. Skeletal Radiol. 42(5):635-47, 2013
                                  6. Walker EA et al: Magnetic resonance imaging of malignant soft tissue neoplasms in the adult. Radiol Clin North Am. 49(6):1219-34, vi, 2011
                                  7. Walker EA et al: Magnetic resonance imaging of soft-tissue masses. Semin Roentgenol. 45(4):277-97, 2010
                                  8. Bidault F et al: Liposarcoma or lipoma: does genetics change classic imaging criteria? Eur J Radiol. 72(1):22-6, 2009
                                  9. Weiss SW et al: Liposarcoma. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 482-93, 2008
                                  10. Murphey MD et al: From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics. 25(5):1371-95, 2005
                                  11. Dei Tos AP et al: Atypical lipomatous tumour/well differentiated liposarcoma. In Fletcher CDM et al: World Health Organisation Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 35-7, 2002
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Abbreviations

                                          • Atypical lipomatous tumor (ALT)
                                          • Well-differentiated liposarcoma (WDL)
                                        • Synonyms

                                          • Atypical lipoma, atypical lipomatous neoplasm, adipocytic liposarcoma, lipoma-like liposarcoma, sclerosing liposarcoma, spindle cell liposarcoma, inflammatory liposarcoma
                                        • Definitions

                                          • Intermediate, locally aggressive neoplasm composed predominantly of fat; no metastatic potential
                                          • WHO designation: ALT/WDL
                                          • WDL and ALT describe lesions that are identical both morphologically and karyotypically; named selected is based on location
                                          • WDL is now used for tumors of retroperitoneum, mediastinum, and deep pelvis
                                          • ALT includes tumors of extremities and superficial sites

                                        IMAGING

                                        • General Features

                                          • Imaging Recommendations

                                            • Radiographic Findings

                                              • CT Findings

                                                • MR Findings

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Gross Pathologic & Surgical Features

                                                        • Microscopic Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Mashima E et al: Recent advancement in atypical lipomatous tumor research. Int J Mol Sci. 22(3), 2021
                                                                  2. Sbaraglia M et al: Atypical lipomatous tumor/ well-differentiated liposarcoma. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 36-8, 2020
                                                                  3. Kransdorf MJ et al: Lipomatous tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 147-70, 2014
                                                                  4. Bestic JM et al: Sclerosing variant of well-differentiated liposarcoma: relative prevalence and spectrum of CT and MRI features. AJR Am J Roentgenol. 201(1):154-61, 2013
                                                                  5. Brisson M et al: MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification. Skeletal Radiol. 42(5):635-47, 2013
                                                                  6. Walker EA et al: Magnetic resonance imaging of malignant soft tissue neoplasms in the adult. Radiol Clin North Am. 49(6):1219-34, vi, 2011
                                                                  7. Walker EA et al: Magnetic resonance imaging of soft-tissue masses. Semin Roentgenol. 45(4):277-97, 2010
                                                                  8. Bidault F et al: Liposarcoma or lipoma: does genetics change classic imaging criteria? Eur J Radiol. 72(1):22-6, 2009
                                                                  9. Weiss SW et al: Liposarcoma. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 482-93, 2008
                                                                  10. Murphey MD et al: From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics. 25(5):1371-95, 2005
                                                                  11. Dei Tos AP et al: Atypical lipomatous tumour/well differentiated liposarcoma. In Fletcher CDM et al: World Health Organisation Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 35-7, 2002