[Liposarcoma in the head-neck area]

Between 1977 and 1992 four patients with liposarcomas of the head and neck region were treated and regularly reexamined at the ENT department of the University of Tubingen. Our patients were aged 19, 64, 66, and 73 years at primary diagnosis. Three patients were female and one was male. The tumors were located in cheek/parotid gland, the neck, the tracheoesophageal region and larynx/hypopharynx. In three patients complete primary resection was planned. In three cases further surgery was necessary due to recurrences. Two patients are free of tumor for seven and nine years, respectively. One patient was irradiated with 70 Gy four years after primary surgery since she had developed an unresectable recurrence. She died eleven years later aged 79 without residual liposarcoma (autopsy). One patient aged 76 rejected a radical resection and underwent a functional tumor reduction and is alive in fairly good condition. Histologically we found one myxoid and three well-differentiated liposarcomas. Metastatic spread was not observed. Wide tumor excision is the therapy of choice. Unresectable tumors can be irradiated successfully (up to 70 Gy are necessary). Representative studies on the value of chemotherapy have not yet been presented. The main factor in clinical behavior and prognosis of this rare tumor is the histological subtype. While well-differentiated and myxoid liposarcomas show almost no metastasis and good prognosis, the pleomorphic and round cell type do metastasis, recur more often, and have a significantly worse prognosis.