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Musculoskeletal
Diagnosis
Non-Trauma
Soft Tissue Tumors
Adipocytic Tumors
Malignant Adipocytic Tumors
Pleomorphic Liposarcoma
Pleomorphic Liposarcoma
Eric Walker, MD, MHA, FACR, FACHE; Catherine C. Roberts, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Pleomorphic, high-grade sarcoma with variable number of pleomorphic lipoblasts
          • No areas of atypical lipomatous tumor/well-differentiated liposarcoma or other lines of differentiation are present
          • Rarest and most aggressive subtype (~ 5-10% of liposarcomas)

        • Subtype

          • Epithelioid sarcoma (25%)

        IMAGING

        • General Features

          • Radiographic 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. Pedeutour F et al: Pleomorphic liposarcoma. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 45-6, 2020
                              2. Anderson WJ et al: Pleomorphic liposarcoma: updates and current differential diagnosis. Semin Diagn Pathol. 36(2):122-8, 2019
                              3. Wortman JR et al: Neoadjuvant radiation in primary extremity liposarcoma: correlation of MRI features with histopathology. Eur Radiol. 26(5):1226-34, 2015
                              4. Kransdorf MJ et al: Lipomatous tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 167-9, 2014
                              5. Lee SA et al: Encapsulated fat necrosis mimicking subcutaneous liposarcoma: radiologic findings on MR, PET-CT, and US imaging. Skeletal Radiol. 42(10):1465-70, 2013
                              6. Shanbhogue AK et al: Uncommon primary pelvic retroperitoneal masses in adults: a pattern-based imaging approach. Radiographics. 32(3):795-817, 2012
                              7. Weiss SW et al: Liposarcoma. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 510, 2008
                              8. Murphey MD et al: From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics. 25(5):1371-95, 2005
                              9. Mentzel T et al: Pleomorphic liposarcoma. In Fletcher CDM et al: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 34-5, 2002
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Clinical Issues

                                    TERMINOLOGY

                                    • Definitions

                                      • Pleomorphic, high-grade sarcoma with variable number of pleomorphic lipoblasts
                                      • No areas of atypical lipomatous tumor/well-differentiated liposarcoma or other lines of differentiation are present
                                      • Rarest and most aggressive subtype (~ 5-10% of liposarcomas)

                                    • Subtype

                                      • Epithelioid sarcoma (25%)

                                    IMAGING

                                    • General Features

                                      • Radiographic 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. Pedeutour F et al: Pleomorphic liposarcoma. In Fletcher CDM et al: World Health Organization Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 45-6, 2020
                                                          2. Anderson WJ et al: Pleomorphic liposarcoma: updates and current differential diagnosis. Semin Diagn Pathol. 36(2):122-8, 2019
                                                          3. Wortman JR et al: Neoadjuvant radiation in primary extremity liposarcoma: correlation of MRI features with histopathology. Eur Radiol. 26(5):1226-34, 2015
                                                          4. Kransdorf MJ et al: Lipomatous tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 167-9, 2014
                                                          5. Lee SA et al: Encapsulated fat necrosis mimicking subcutaneous liposarcoma: radiologic findings on MR, PET-CT, and US imaging. Skeletal Radiol. 42(10):1465-70, 2013
                                                          6. Shanbhogue AK et al: Uncommon primary pelvic retroperitoneal masses in adults: a pattern-based imaging approach. Radiographics. 32(3):795-817, 2012
                                                          7. Weiss SW et al: Liposarcoma. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 510, 2008
                                                          8. Murphey MD et al: From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics. 25(5):1371-95, 2005
                                                          9. Mentzel T et al: Pleomorphic liposarcoma. In Fletcher CDM et al: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 34-5, 2002