Ortho Oracle - orthopaedic operative atlas
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- Two Forms:
    - low grade myxoid liposarcoma;
         - most common;
         - occurs in young adults;
         - in myxoid liposarcoma, lipoblasts are dispersed in anastomosing capillary framework;
         - fine reticular vascular pattern;
    - high grade pleomorphic liposarcoma:
         - pleomorphic liposarcoma is more common in older patients;
         - enlarging but painless mass in the buttocks (most common site), proximal thigh, or upper arm is the classic presentation;
         - more aggresive tumor which tends to invade bone;
         - have amorphously arranged large vascular lakes;
         - contains large, pyknotic, bizarre, mononucleated cells in combinatination with immature lipoblasts;

- Differential Dx:
    - lipoma
    - most liposarcomas occur proximal to the knee and elbow;

- Radiographic Studies:
        - Angiography:
vascularity of tumor is best demonstrated by angiography;
        - Bone Scan:
                - marked increase in radioisotope uptake in the early phase of bone scan;
        - CT Scan:
                - radiolucency noted on CT may suggest hisogenesis in low grade, well differentiated lesions with a high fat content;

- Treatment:
    - stage I myxoid lesions: treated w/ wide surgical excision,
    - stage II pleomorphic lesions:
           - requires wide excision supplemented w/ XRT, or radical resection, or amputation

Atypical Lipomatous Tumors/Well-differentiated Liposarcomas: Clinical Outcome of 67 Patients

Primary myectomy for sarcoma