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Routine MDM2 FISH Testing and Preoperative Biopsy Reduces Recurrence Rate of Atypical Lipomatous Tumours
Samuel O H Ching1, Anderson S M Leung2, Raymond C H Yau2
1Department of Pathology, School of Clinical Medicine, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Journal of Surgical Oncology
|July 29, 2026
Summary
Routine MDM2 FISH testing on preoperative biopsy aids in diagnosing atypical lipomatous tumors (ALT), especially those with benign features. This diagnostic approach reduces recurrence risk by enabling appropriate surgical planning for ALT.
Area of Science:
- Oncology
- Surgical Pathology
- Molecular Diagnostics
Background:
- Atypical lipomatous tumors (ALT) can be challenging to distinguish from benign lipomas on biopsy.
- MDM2 FISH testing is increasingly used for ALT diagnosis, but its clinical impact on recurrence is unclear.
Purpose of the Study:
- To investigate if routine MDM2 FISH testing on preoperative biopsy reduces recurrence risk in ALT patients.
- To compare clinicopathological parameters and outcomes between ALT and lipoma patients.
Main Methods:
- Retrospective analysis of 336 patients with MDM2-verified well-differentiated lipomatous tumors (ALT and lipomas).
- Comparison of clinicopathological data, diagnostic approaches, and recurrence rates.
- Evaluation of the association between preoperative MDM2 FISH testing and recurrence.
Main Results:
- ALT patients were older, had larger tumors, and more deep extremity lesions than lipoma patients.
- 25% of ALT biopsy specimens showed benign morphology, highlighting diagnostic challenges.
- Preoperative MDM2 FISH testing in ALT patients was associated with a significantly lower recurrence rate (16.2% vs. 56.7%) and higher rates of extracapsular excision.
Conclusions:
- Routine MDM2 FISH testing on preoperative biopsy definitively diagnoses ALT, particularly lipoma-like cases.
- This testing facilitates surgical planning for extracapsular excision.
- MDM2 FISH testing reduces local recurrence rates in ALT.
