Liposarcoma is a rare and malignant tumour that originates in fat cells. It can appear anywhere in the body but is most commonly found in the limbs and the abdominal cavity. Understanding the types, symptoms, and diagnostic methods for liposarcoma is crucial for timely and effective treatment.

What are the types of liposarcoma?

Liposarcoma is classified into several subtypes, each with unique characteristics and behaviours. The main types include:

1. Well-Differentiated Liposarcoma

• This is the most common and least aggressive form. It tends to grow slowly and has a lower chance of spreading to other parts of the body.
• Symptoms: Often asymptomatic, but larger tumours can cause pain or discomfort by pressing on surrounding tissues.

2. Myxoid Liposarcoma

• This type is intermediate in terms of aggressiveness. It is characterised by a mix of fat cells and a mucoid (gel-like) matrix.
• Symptoms: Can cause swelling and discomfort, typically in the thighs or retroperitoneal space.

3. Round Cell Liposarcoma

• Considered a more aggressive variant of myxoid liposarcoma, it has a higher likelihood of metastasis.
• Symptoms: Similar to myxoid liposarcoma but with a higher risk of spreading to distant organs.

4. Pleomorphic Liposarcoma

• This is the rarest and most aggressive form. It consists of cells that vary widely in shape and size.
• Symptoms: Rapidly enlarging mass, often associated with pain and functional impairment of the affected area.

5. Dedifferentiated Liposarcoma

• This subtype arises from well-differentiated liposarcoma and transforms into a more aggressive form.
• Symptoms: Pain, rapid growth, and potential functional impairment depending on the tumour's location.

What are the common symptoms of liposarcoma?

Liposarcomas can vary significantly in their presentation depending on their type and location. Common symptoms include:

• Lump or Mass: A noticeable lump under the skin, often painless but can become painful as it grows.
• Pain or Discomfort: Particularly if the tumour presses against nerves, muscles, or internal organs.
• Swelling: In the affected area, which may restrict movement or cause functional impairments.
• Weight Loss: Unexplained weight loss can occur, especially in more aggressive forms.
• Fatigue: General feeling of tiredness or weakness.

How is liposarcoma diagnosed?

Early diagnosis is essential for effective treatment and a better prognosis. The diagnostic process typically involves:

1. Physical Examination:

An initial assessment by a healthcare professional is performed to identify any lumps or abnormalities.

2. Imaging Studies:

• MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, helping to determine the tumour's size and extent.
• CT (Computed Tomography) Scan: This is often used to assess the presence of metastasis and the involvement of other organs.
• Ultrasound: Useful for evaluating superficial tumours and guiding biopsy procedures.

3. Biopsy:

• Core Needle Biopsy: A sample of the tumour tissue is taken using a needle for microscopic examination.
• Surgical Biopsy: In some cases, a larger tissue sample is obtained through a minor surgical procedure.

4. Histopathological Analysis:

• Examining the biopsy sample under a microscope to identify the type of liposarcoma and its characteristics.

5. Molecular Testing:

• Genetic and molecular tests may be conducted to identify specific mutations and guide targeted therapies.

What is the first-line treatment for liposarcoma?

The treatment approach for liposarcoma depends on the type, size, location, and stage of the tumour, as well as the patient's overall health. Common treatment modalities include:

1. Surgery:

• Wide Local Excision: Removing the tumour along with a margin of healthy tissue to ensure complete removal.
• Limb-Sparing Surgery: In cases where the tumour is in a limb, efforts are made to remove the cancer without amputating the limb.
• Reconstructive Surgery: It may be necessary to restore function and appearance after tumour removal.

2. Radiation Therapy:

• Often used before surgery to shrink the tumour or after surgery to eliminate any remaining cancer cells.
• External Beam Radiation: Targeted radiation to the tumor site.
• Brachytherapy: Placement of radioactive material inside or near the tumour.

3. Chemotherapy:

• Eribulin: A chemotherapy medication used in the treatment of liposarcoma, particularly for advanced or metastatic cases.
• Chemotherapy can be used before surgery (neoadjuvant) to shrink tumours or after surgery (adjuvant) to kill any remaining cancer cells.
• Combination Chemotherapy: Using multiple chemotherapy agents to enhance effectiveness.

4. Targeted Therapy:

• Involves medications that specifically target cancer cells based on their genetic or molecular profile.
• Molecular Testing: Helps identify patients who may benefit from targeted therapies.

5. Clinical Trials:

• Patients may have access to experimental treatments through clinical trials, offering hope for improved outcomes.

Prognosis for liposarcoma

The prognosis for liposarcoma varies based on the type and stage of the tumour. Well-differentiated liposarcomas generally have a better prognosis than more aggressive forms. Regular follow-up is crucial to monitor for recurrence or metastasis.

In advanced cases, treatments such as the Ebunat 0.5mg Injection, which contains Eribulin, may be considered to manage symptoms and improve quality of life. This chemotherapy medication has shown promise in controlling tumour growth and extending survival in some patients.

Regular check-ups are recommended to monitor for new symptoms or changes in health status. Addressing pain, mobility issues and psychological support for patients and families can aid in better treatment.