What is Round Cell Liposarcoma?

Round cell liposarcoma is a malignant (cancerous) and aggressive soft-tissue sarcoma. It is fairly similar to a myxoid liposarcoma, and it is believed that myxoid liposarcomas can transgress into round cell liposarcomas. Additionally, round cell liposarcomas appear similar to a myxoid liposarcoma with the exception that myxoid stroma is not present in round cell liposarcomas. Round cell liposarcomas most commonly occur in the soft tissues of the upper and lower extremities, and without effective treatment, may metastasize, or spread, to other parts of the body

Causes

• • Aside from the uncontrollable growth of abnormal cells to create a fatty mass, there is no known cause.

Biological Behavior

• • Round cell liposarcoma appears similar to a myxoid liposarcoma except that myxoid stroma is not present.

Signs and Symptoms

• • Most patients present with an enlarging, painless, and mobile mass.
• • About 30% of patients may have dull aching pain or tenderness.

Who is usually affected?

• • The majority of cases occur between the ages of 50-70. Rarely occurs in children.
• • Slightly more common in males and most frequent in the Caucasian population.

Diagnosis

• • The work-up for round cell liposarcoma often consists of a physical examination, X-ray, MRI, CT, and bone scans. Also, a bone scan, CT PET scan, and CT chest/abdomen/pelvis may be ordered to check if the tumor has spread, or metastasized, to the chest/abdomen/ pelvis or other parts of the body. The diagnosis is often confirmed with a biopsy, which samples the tumor for further analysis.

Common Sites Involved

• • Lower extremities- the thigh is the most common site.
• • Upper extremities
• • Retroperitoneum
• • Head/neck region
• • Can metastasize to lungs, liver, lymph nodes and other bones.

Risk to your limbs

Round cell liposarcoma is a malignant sarcoma that has risks of recurrence and metastasis. Similar to all soft-tissue sarcomas, round cell liposarcomas grow in the soft-tissues of the extremities and compromise or destroy the affected soft-tissue and muscles. These tumors can compress or stretch important vessels and nerves, and occasionally wrap around these structures making it difficult to remove the mass without an amputation. They also have the potential to invade adjacent bones. Without treatment, liposarcoma can metastasize or spread throughout the body, with the lungs, liver, and bones being the most common sites.

Radiographic imaging is used to help form a diagnosis. These include X-Ray, MRI, CT and Bone Scans. 

An example of an MRI is shown.

Treatment of Round Cell Liposarcoma

The treatment of round cell liposarcoma is very similar to the treatment of myxoid liposarcoma. The treatment includes surgical excision through wide or radical resections. Limb-sparing surgery is performed whenever possible, however if the tumor compresses, stretches, or is wrapped around vital nerves and vessels then an amputation may be performed. Additionally, radiation and/or chemotherapy may be administered to treat round cell liposarcoma.

Surgery

Surgical treatment includes wide or radical resections to remove the complete tumor and additional margins. The removal of additional, surrounding margins ensures that the tumor is completely removed and decreases the chances of the tumor coming back.

Chemotherapy

Chemotherapy is a systemic treatment option for some cancers, meaning the chemotherapy drugs travel throughout the body and can kill the cancerous cells that have metastasized, or spread throughout. Chemotherapy is used to treat cancer, control/prevent cancer from spreading, and ease the symptoms related to the cancer.  There are various drugs used in chemotherapy, so the combinations of drugs administered and the number of cycles may differ between each person and tumor. Lastly, chemotherapy may be used in conjunction with other treatments, specifically local treatments such as surgery.

Radiation

Radiation is a treatment option for some cancers. Radiation therapy is a localized treatment that utilizes high-energy particles or waves to kill cancerous cells. Because radiation therapy is a localized treatment, it only affects the area in which it is set to target and therefore eliminates the risks of damaging healthy cells throughout the body. Not only is it used to treat cancer, but it can also decrease the chances of the cancer from recurring. Lastly, radiation may be used in conjunction with other treatments, such as surgery or chemotherapy, to treat cancers.