Histomorphological and molecular characteristics of liposarcoma (Review)

Liposarcomas represent the most prevalent subtype of soft-tissue sarcomas, comprising 15-20% of all documented cases. However, sarcomas demonstrate notable clinical and pathological variability, which complicates the processes of diagnosis and treatment. Histomorphological analysis can produce inconsistent results due to inter-examiner variability, which highlights the need for more reliable biomarkers. Genetic and epigenetic alterations may delineate the biological behavior of liposarcomas and assist in the prediction of liposarcoma prognosis. The present review highlights the related genomic alterations in sarcoma and their associations with relevant histomorphology, predilection, targeted therapy and prognosis. Well-differentiated and dedifferentiated liposarcomas exhibit amplified genes, MDM2 proto-oncogene and cyclin-dependent kinase 4, which are potential targets for therapy. Myxoid liposarcoma, characterized by the chromosomal translocations t(12;16) with fused in liposarcoma-DNA damage-inducible transcript 3 protein (DDIT3) fusion and t(12;22) with Ewing sarcoma RNA-binding protein 1-DDIT3 fusion, demonstrate a favorable response to treatment; however, myxoid liposarcoma displays elevated recurrence rates. Moreover, the complex karyotype and lack of specificity in pleomorphic liposarcoma are associated with poor treatment outcomes and increased recurrence rates. Integration of morphological features with molecular biomarkers may potentially enhance diagnosis, facilitate targeted therapies and improve sarcoma prognosis in the future.