Giant Liposarcoma in Left Thigh

Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Giant Liposarcoma in Left Thigh

Leopoldo Maizo1 Fedor Marín2
1 2
Orthopedic Surgeon. Medical Specialist in Joint Orthopedic Surgeon. Medical Specialist in Musculoskeletal
Replacement Surgery. Tumors.
Abstract:- Giant Liposarcoma In Left Thigh The prognosis of the evolution of the pathology (5). The World
liposarcoma is located epidemiologically second of all Health Organization (WHO) currently admits four types of
tumors affecting soft tissues in adults, with an incidence liposarcoma:
between the 4th and 6th decade of life and a slight
tendency towards males, their location commonly can  Well-differentiated (or atypical lipoma): the most
have observed in the lower extremities by 80%, however, frequent (50% of all liposarcomas). Low degree of
it is important to mention that may appear in other areas aggressiveness (does not metastasize but can relapse
of the body such as chest or abdominal cavity. It can be locally). It can dedifferentiate (6,7).
classified according to the degree of aggressiveness of the  Myxoid: Intermediate degree of aggressiveness, it
same in 4 subtypes being the most common and less includes as the highest grade subtype, the variant called
aggressive well-differentiated liposarcoma. The "round cell". It is the most frequent subtype in children.
treatment of choice is surgical and aesthetic and There is a risk of metastasis, especially in the round cell
functional results are almost always satisfying. variant (6,7).
 Pleomorphic: The most infrequent (5-10% of
 Case Report: liposarcomas). It can simulate a malignant
A male patient aged 62 who presented progressive fibrohistiocytoma or even a carcinoma or melanoma. It
increase in volume in the left thigh, after imaging and presents a high risk of local recurrence and metastasis
analysis of biopsy is scheduled for surgical resection of (6,7).
well-differentiated liposarcoma. marginal resection is  Undifferentiated: It is a high grade sarcoma (malignant
performed with biopsy confirmatory free margins fibrohistiocytoma, fibrosarcoma or others) originated on
control tumor tissue, without infectious complications a well-differentiated liposarcoma. It is more frequent in
and with adequate functional recovery. retroperitoneal lesions and has a high risk of metastasis
(6,7).
Keywords:- Liposarcoma, Tumor, Soft Tissue.
The main consideration is the preservation of the
I. INTRODUCTION extremity, which will be determined by the type of
liposarcoma. Although amputation has historically been the
Although a high percentage of tumors located in soft surgical option of choice for these tumors, currently most of
tissues are usually benign, it is important to be aware of the them can be treated by limb-sparing surgery. However, the
existence of malignant tumors in order to make an accurate performance of limb-sparing surgery should not compromise
differential diagnosis (1). Liposarcoma is epidemiologically the primary oncologic goal, which is cure, and should ensure
located in the second place of all tumors affecting soft a limb whose function is better than that which would be
tissues in adults, representing 10 to 30% of all tumors provided by a post-amputation prosthesis (8). The resection
affecting soft tissues, with an incidence between the 4th and of liposarcoma must be performed in a wide manner, since
6th decade of life and a slight tendency towards the male this can prevent the lesion from recurring (12).
sex, Its location can be commonly observed in the lower
extremities in 80% (3), particularly in the thigh where its The use of chemotherapy and radiotherapy before and
location predominates in 50%, gluteal region and inguinal after the surgical procedure is mentioned in a very
region, however it is important to mention that it can appear controversial way due to its advantages and disadvantages
in other areas of the body such as the thorax, mediastinum, that can be generated, the indication of radiotherapy sessions
retro peritoneum, small intestine and mesentery (2). can give us benefits since the tumor can really diminish in
Liposarcoma in the thigh is located mainly in the deepest size after its application, making the surgery more
layers, in its initial stages there are no symptoms, so most of technically feasible. On the other hand, surgical
the time it is usually detected with the presence of a palpable complications increase, especially those related to the
mass that increases progressively, many times this increase incision area, where the complications are 25% (9,11).
in volume can occupy large spaces and can cause
compression of blood vessels and nerves (4). The It has been suggested, however, that the improvement
dimensions of the liposarcoma and the compromise it in the oncologic prognosis of patients with liposarcomas and
generates according to its location can be determined by the decrease in the incidence of permanent late
means of X-ray studies, Magnetic Resonance and Computed complications would justify the use of preoperative
Axial Tomography (11), the surgical treatment will depend radiotherapy, despite the higher rate of complications (10).
on a good histopathological study which will determine the
IJISRT23JAN1147 www.ijisrt.com 1704

ISSN No:-2456-2165
The role of chemotherapy in the treatment of In April 2016, surgery was performed under general
liposarcoma remains controversial; optimally, its use should anesthesia, anterolateral approach of the left thigh was
be assessed in each individual case. performed by double longitudinal incision of approximately
40 cm, section of the femoral fascia, identification of the
II. CASE REPORT undamaged femoral bundle, direct visualization of the soft
tissue tumor and peripheral divulsion of the tumor
This is a 62-year-old male patient with progressive respecting 2 cm of healthy tissue, identification of tumor
enlargement of 4 years of evolution in the left thigh, who vascular pedicle and satisfactory ligation of the same,
came to the outpatient clinic of musculoskeletal tumors of phenolization of the nerve branches, adequate marginal
the Military Hospital Coronel Elbano Paredes Vivas in June resection of the tumor with section of 50% of the rectus
2015, in view of functional limitation and mild pain during femoris, presence of adhesions of distal portion of vastus
walking, it is indicated complementary imaging studies and intermedius, synthesis by planes and final closure,
take a biopsy in July 2015, where the result of the same transferring the patient in stable general conditions to the
reports well-differentiated liposarcoma. recovery area.
Fig 1 An Increase in Volume can be Seen in the Fig 3 Marginal Resection of Liposarcoma of 3.8 Kg.
Anterolateral Aspect of the Left Thigh.
A sample of tumor piece of 40 x 20 cm approx. is sent
 Nuclear magnetic resonance images show a large for a new biopsy study and the patient is discharged
volume tumor mass of approximately 16.47 cm in satisfactorily after 72 hours. In May 2016, biopsy results
transverse length, 11.52 cm thick and 37.65 cm in were obtained confirming the presence of well-differentiated
vertical length. liposarcoma with tumor-free margins.
Fig 4 Aspect of the Surgical Scar on the Left Thigh
Fig 2 Nuclear Magnetic Resonance of the Left Thigh before After 4 months of follow-up, surgical scar without
Surgery complications, left thigh with hypotrophy of muscle mass
and without limitation of hip and knee joint mobility
compared to the contralateral limb. Patient denies pain and

ISSN No:-2456-2165
currently with adequate reintegration and in the beginning of [3]. Ortiz-Ibáñez, B., Amaya, J. V., Baixauli, F., Angulo,
physical therapy and rehabilitation for strengthening of M., Mayordomo-Aranda, E., & Barrios, C. (2015).
muscle groups of the anterior compartment of the left thigh. Surgical resection of massive liposarcomas at the
extremities: a 10-year experience in a referral
III. DISCUSSION musculoskeletal sarcoma unit.World Journal of
Surgical Oncology, 13, 206.
Well-differentiated liposarcoma represents the most [4]. Costea, R., Vasiliu, E., Zarnescu, N., Hasouna, M., &
frequent subtype of liposarcoma, it increases progressively Neagu, S. (2011). Large thigh liposarcoma–
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The treatment of choice even today continues to be J., Meller, I., & Merimsky, O. (2006). Liposarcoma in
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results must resect the whole piece with adequate resection adjuvant radiotherapy. Bone & Joint Journal, 88-
margins of approximately 1cm (14); which is particularly B(12), 1647-1651.Accessed August 03, 2016.
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since they present a pseudocapsule. Survival and recurrence- MI. Malignant fatty tumors: classification, clinical
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IV. CONCLUSION Classifications in Brief: Enneking Classification:
Benign and Malignant Tumors of the Musculoskeletal
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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology

Giant Liposarcoma in Left Thigh

IJISRT23JAN1147 www.ijisrt.com 1704

Fig 4 Aspect of the Surgical Scar on the Left Thigh

IJISRT23JAN1147 www.ijisrt.com 1705

IJISRT23JAN1147 www.ijisrt.com 1706

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