Also known as well-differentiated liposarcoma, well-differentiated liposarcoma is the most common subtype of liposarcoma. These tumors nearly always occur in adults and have no gender predilection. They are slow-growing tumors that arise most commonly in the deep soft tissues of the proximal extremities (thigh) and the retroperitoneum. Occasionally retroperitoneal liposarcomas may present as groin masses because of local extension into the peritoneal-lined scrotal sac and therefore may simulate a groin hernia.
Low-grade liposarcoma, also known as well-differentiated liposarcoma, are malignant sarcomas that have various risks to your limbs. Like all soft-tissue sarcomas, these liposarcomas grow in the soft-tissues of the extremities and compromise or destroy the affected soft-tissue and muscles. These tumors can compress or stretch important vessels and nerves, and occasionally wrap around these structures making it difficult to remove the mass without an amputation. They also have the potential to invade adjacent bones. Although metastasis is rare, without treatment, low-grade liposarcomas can metastasize or spread throughout the body, with the lungs, liver, and bones being the most common sites.
Radiographic imaging is used to help form a diagnosis. These include X-Ray, MRI, CT and Bone Scans.
An example of MRI is shown.
The treatment for low-grade liposarcoma includes surgical excision with a wide excision if possible; however most are marginally excised. Limb-sparing surgery is performed whenever possible, however if the tumor compresses, stretches, or is wrapped around vital nerves and vessels then an amputation may be performed. Typically, chemotherapy isn't used, as low-grade tumors are often resistant to standard cytotoxic chemotherapies, and no survival benefit derived from adjuvant chemotherapy have been published. Adjuvant radiation therapy is also not recommended, as this sarcoma is generally not radiosensitive and has a less than 1% risk of distant metastasis. The benefit of radiation does not outweigh the risk.
Surgical treatment includes wide or radical resections to remove the complete tumor and additional margins. The removal of additional, surrounding margins ensures that the tumor is completely removed and decreases the chances of the tumor coming back.
Chemotherapy is a systemic treatment option for some cancers, meaning the chemotherapy drugs travel throughout the body and can kill the cancerous cells that have metastasized, or spread throughout. Chemotherapy is used to treat cancer, control/prevent cancer from spreading, and ease the symptoms related to the cancer. There are various drugs used in chemotherapy, so the combinations of drugs administered and the number of cycles may differ between each person and tumor. Lastly, chemotherapy may be used in conjunction with other treatments, specifically local treatments such as surgery.
I've seen many doctors and I can confidently attest Dr. Wittig is the preeminent orthopaedic specialist. He is genuinely kind and caring, as he demonstrated by completely addressing my concerns and compassionately relating to what I was dealing with. He clearly outlined the plan of attack, and recommended the two additional doctors who would become part of my 'team'. Dr. Wittig was so effective in allaying our fears and bringing us optimism. My surgery was significant, but I was up and walking the next day and back at the gym 5 weeks later. This is further testament to Dr. Wittig's skill. He saved my leg and my life, and I feel so very blessed to say he is my doctor. I have already recommended him to others, and I will continue to do so. I would trust him with my closest family and lifelong friends. BEST DOCTOR EVER.
Myself and my amazing team are dedicated to saving your life and your limb. Losing a limb because of a tumor can be a terrifying experience. But, it does not have to be the only option. I’ve spent 20+ years as a Board-Certified Orthopedic Surgeon and Orthopedic Oncologist.
I’ve devoted my career to helping children and adults afflicted with bone and soft tissue masses by performing complex limb saving surgeries. Most patients can have their limb saved, which may require innovative techniques.
Patients afflicted with musculoskeletal tumors have complex conditions that are best taken care of at large hospitals. I am the Chairman of Orthopedics and Chief of Orthopedic Oncology at Morristown Medical Center. My philosophy is a multidisciplinary team approach, working together to tailor treatment to individual patients. Education and research are essential to my practice, providing the best setting for extraordinary patient care. Because of this, we have some of the top results in the country.