Liposarcoma Clinical Presentation

Updated: Apr 17, 2023
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Liposarcomas are most commonly found in the extremities; in the retroperitoneum; and, less often, in the head and neck area. These tumors are most likely to arise from deep-seated, well-vascularized structures than from submucosal or subcutaneous fat. Myxoid liposarcoma is usually evident as a deep-seated mass in the lower extremity of adults, but it may be less commonly be first evident as a primary subcutaneous mass. [20]

Liposarcomas of all subtypes can occur in the cutis and the subcutis; however, their primary occurrence in the skin is rare. Clinically, all cases of liposarcomas in the skin tend to grow in an exophytic manner, presenting as either dome-shaped or polypoid lesions. In all patients, the neoplasm is centered in the dermis, and it has a minimal tendency to grow downward into the underlying subcutaneous adipose tissue.

Most patients with liposarcoma have no symptoms until the tumor is large and impinges on neighboring structures, causing tenderness, pain, or functional disturbances. In the retroperitoneal area, where liposarcoma is detected at a late stage, the tumor may grow to a substantial size, weighing several pounds at the time of diagnosis. In general, liposarcoma grows silently, and the patient's estimation of the clinical duration is often unreliable. The patient eventually becomes aware of a swelling or a mass and reports this finding to the physician.

Patients may report the following:

  • Associated episode of trauma to the region containing the mass

  • Painful swelling (occurs in one third of cases for as long as 6 mo)

  • Decreased function (ie, range of motion)

  • Numbness

  • Enlargement of varicose veins

  • Fatigue

  • Abdominal pain

  • Weight loss

  • Nausea

  • Vomiting



A case report describes liposarcoma complicating pregnancy. [21] A myxoid liposarcoma was described in a psoriatic patient on adalimumab. [22] A tumor-to-tumor metastasis of a prostatic adenocarcinoma metastasizing to a myxoid liposarcoma has been described, a most unusual coincidence. [23]