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Management Algorithm for Atypical Lipomatous Tumours: A Retrospective Case Series.

Muhammad Umair1, Maria Mahmood1, Adeel Zafar1

  • 1Department of Surgery, Tallaght University Hospital, Dublin, IRL.

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|February 13, 2025
PubMed
Summary
This summary is machine-generated.

Atypical lipomatous tumours (ALTs) are often misnamed, underestimating recurrence risk. This study proposes a management algorithm to differentiate ALTs from lipomas, aiding patient care and risk stratification.

Keywords:
algorithmatypical lipomatous tumourlipomawell-differentiated liposarcomaswide local excision (wle)

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Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Atypical lipomatous tumours (ALTs), also known as low-grade well-differentiated liposarcomas (WDLs), present diagnostic challenges due to complex radiological and histological features.
  • The current nomenclature for ALTs may underestimate their potential for local recurrence, necessitating a clear management strategy.

Purpose of the Study:

  • To evaluate the clinical, radiological, and histological characteristics of atypical lipomatous tumours.
  • To develop and propose a management algorithm for differentiating ALTs from benign lipomas.

Main Methods:

  • A retrospective analysis of a prospectively maintained database from Tallaght University Hospital (2013-2019).
  • Inclusion of patients with atypical lipomatous tumours, detailing demographics, tumour characteristics, radiological findings, treatment, and recurrence data.

Main Results:

  • Out of 607 lipomatous tumours resected, 40 lesions in 37 patients were classified as ALTs.
  • The mean age of ALT patients was 56.15 years, with the lower limb being the most common location.
  • Three patients (7.5%) experienced local recurrence requiring re-operation; two patients (5%) needed pre-operative angio-embolisation.

Conclusions:

  • Distinguishing atypical lipomatous tumours from lipomas is crucial for appropriate patient management.
  • MRI findings, including increased intratumoural vascularity and septation, may indicate malignant potential in adipocytic tumours.
  • A proposed management algorithm can assist in stratifying subcutaneous lesions.