Diagnostic Considerations

Also consider the following:

Cellular angiofibroma
Solitary fibrous tumor
Cutaneous neurofibroma
Malignant schwannoma
Rhabdomyosarcoma
Leiomyosarcoma
Fibrous histiocytoma
Benign lipoblastoma in infants and children
Actinomycosis ^[24]
Salivary gland tumors^[25]

Late granulomatous reactions from silicone may appear in a site different from that of the injection and may cause an incorrect diagnosis of liposarcoma.^[26]Silicone implants for chin augmentation may create a tissue reaction that mimics a low-grade liposarcoma.^[27]

Myxofibrosarcoma, one of the most common soft tissue sarcomas of elderly patients, may histologically resemble pleomorphic liposarcoma.^[28]

Primary liposarcoma may be evident as metastatic liposarcoma to the head and neck region, including the gingival mucosa.^{[29, 30]}

Spindle cell lipomas are benign lipomatous tumors that may require histological distinction from liposarcoma. These lipomas are typically seen in the posterior neck, shoulder, or upper back of older males.^[31]

Because cutaneous liposarcoma is extremely rare, the physician must rule out a metastatic lesion.

Differential Diagnoses

Workup

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Miller V, Hoellwarth JS, Hankins ML, McGough R, Schoedel K. Tumor-to-Tumor Metastasis: Prostate Carcinoma Metastatic to Soft Tissue Sarcoma, a Previously Unreported Event. Int J Surg Pathol. 2020 Apr. 28 (2):196-199. [QxMD MEDLINE Link].
Monteiro EVE, Gaspar J, Paiva C, Correia R, Valente V, Coelho A, et al. Abdominal Actinomycosis misdiagnosed as liposarcoma. Autops Case Rep. 2020 Jan-Mar. 10 (1):e2020137. [QxMD MEDLINE Link].
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Media Gallery

Computed tomography (CT) scan of a left thigh shows a huge mass (arrows) with predominant fat attenuation. The central soft-tissue component (asterisk) and thick, internal septations are consistent with liposarcoma.

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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Coauthor(s)

Santiago A Centurion, MD Dermatologist, Dermatology Associates of Central NJ

Santiago A Centurion, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, American Society of Dermatopathology, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American College of Rheumatology

Disclosure: Received income in an amount equal to or greater than $250 from: Biogen US (Adjudicator for study entry cutaneous lupus erythematosus); Priovant (Adjudicator for entry into a dermatomyositis study); IQVIA (Serono - adjudicator for a study of cutaneous LE) <br/>Received honoraria from UpToDate for author/editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for these trust accounts for: Stocks held in various trust accounts: Allergen; Amgen; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble;; Celgene; Gilead; CVS; Walgreens; Bristol-Myers Squibb.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Jacek C Szepietowski, MD, PhD Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Received consulting fee from Orfagen for consulting; Received consulting fee from Maruho for consulting; Received consulting fee from Astellas for consulting; Received consulting fee from Abbott for consulting; Received consulting fee from Leo Pharma for consulting; Received consulting fee from Biogenoma for consulting; Received honoraria from Janssen for speaking and teaching; Received honoraria from Medac for speaking and teaching; Received consulting fee from Dignity Sciences for consulting; .

Acknowledgements

Matthew J Trovato, MD Fellow, Division of Plastic Surgery, Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.