Learning objectives
The aim of this revision is:
- To review the main classification of Soft Tissue Tumors with fat component.
- To identify the most common radiological findings of typical lipomas,
lipomas variants,
atypical lipomas and well differentiated liposarcomas (WDL).
Background
Lipomatous tumors are common mesenchymal lesions.
They are classified as benign,
intermediate or malignant. Fig. 2 Lipomas are the most common benign soft tissue neoplasms whereas liposarcomas rank first among soft tissue sarcomas and they can be classified as intermediate or malignant.
[1]
The characteristic radiological findings of these lesions may overlap so it could be difficult to make a correct diagnosis. Fig. 3
Findings and procedure details
The radiological differentiation between lipoma and WDL seems to be clear.
The problem lies in distinguishing this tumor with different variants of lipomas,
as they can exhibit analogous radiological and histological features.
[2]
There is a wide range of histological subtypes and we classified this lesions as: Fig. 4
- Benign tumors: lipomas,
lipomatosis and its variants (angiolipoma,
myolipoma,
chondroid lipoma,
hibernoma...).
- Intermediate tumors: WDL or atypical lipomas.
Benign lipomatous tumors
Lipomas
More frequently affect patients between fifty to seventy years.
They usually are...
Conclusion
Imaging findings let radiologists distinguish,
in the majority of cases,
typical lipomas of WDL.
However,
the appearance of lipomas variants can make complicated the differential diagnosis.
Therefore it is important for radiologist to be familiar with the main imaging findings to guide towards the correct diagnosis.
Fig. 25
References
1-De Schepper AM (Editor) F.Vanhoenacker and P.M.Parizel J.
Gielen (Coeditors).
Imaging of soft tissues tumors.
3rd edition.
Germany.
Springer.
2006.
2- Brisson M,
Kashima T,
Delaney D,
Tirabosco R,
Clarke A,
Cro S,
Flanagan AM,
O'Donnell P.MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification.
Skeletal Radiol.
2013;42:635-647.
3- Drevelegas A,
Pilavaki M,
Chourmouzi D.
Lipomatous tumors of soft tissue: MR appearance with histological correlation.
Eur J Radiol.
2004;50:257-67.
4- Arce JD,
García C,
Otero J,
Villanueva...