Liposarcoma Assessment and Referral in London

Understanding Liposarcoma

Liposarcoma is a malignant tumour originating from adipocytes (fat cells). Unlike lipomas, which are harmless, liposarcomas have cancerous potential. They are classified as soft tissue sarcomas and account for approximately 20% of all such tumours. Liposarcomas often occur in the deep tissues of the thigh, behind the knee, or in the retroperitoneal space of the abdomen.

Causes and Risk Factors

The precise cause of liposarcoma is not known. However, risk factors and associations include:

• Genetic mutations: Changes in chromosomes and gene expression (such as MDM2 amplification) drive tumour growth.
• Age: Most common between 40–60 years.
• Previous radiation exposure: Rare cases occur in previously irradiated tissues.
• Syndromic links: Certain rare inherited syndromes increase sarcoma risk, though most liposarcomas are sporadic.

Symptoms of Liposarcoma

Liposarcomas can present differently depending on their location and growth rate. Common features include:

• A deep, enlarging lump that feels firm and fixed
• Painless growth initially, but pain may develop as tumour enlarges
• Swelling or pressure symptoms when in confined areas
• Weight loss, fatigue, or reduced appetite in advanced cases

Types of Liposarcoma

• Well-differentiated liposarcoma: Slow growing, low-grade, unlikely to spread but may recur locally.
• Myxoid liposarcoma: Intermediate behaviour, risk of spread to unusual sites such as bone.
• Pleomorphic liposarcoma: Aggressive, high-grade form with significant metastatic potential.
• Dedifferentiated liposarcoma: Starts as well-differentiated, then transforms into aggressive subtype.

Liposarcoma Diagnosis

Diagnosis requires a combination of clinical examination, imaging, and biopsy:

• Imaging: MRI and CT scans help assess tumour size, depth, and relationship to surrounding structures.
• Biopsy: Core needle biopsy or excisional biopsy confirms cancerous nature.
• Histology: Pathological analysis determines subtype and grade, guiding treatment.

Liposarcoma Treatment Options

Treatment of liposarcoma is multidisciplinary and often requires care in specialist sarcoma centres. Options include:

• Surgery: Wide local excision is the mainstay, aiming for complete removal with clear margins.
• Radiotherapy: Often used before or after surgery to reduce recurrence risk.
• Chemotherapy: Reserved for advanced, high-grade, or metastatic cases. Effectiveness varies by subtype.
• Targeted therapies: Newer treatments are under research, particularly for molecularly defined subtypes.

Living with Liposarcoma

A diagnosis of liposarcoma can be overwhelming. Management requires regular follow-up with imaging to detect recurrence or spread. Emotional support, rehabilitation, and multidisciplinary input are essential for maintaining quality of life.

Your first visit — what to expect

1. History: Review of symptoms, duration of lump, and medical history.
2. Examination: Clinical evaluation of lump size, depth, and mobility.
3. Investigations: MRI/CT and biopsy arranged if suspicious features present.
4. Treatment discussion: Referral to specialist sarcoma centre for surgery/oncology care.
5. Follow-up: Long-term monitoring with scans and clinical reviews.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 21 August 2025