Dedifferentiated Liposarcoma is a malignant (cancerous), soft-tissue sarcoma that most commonly occurs in the retroperitoneum, or the area in the back of the abdomen. It is an atypical liposarcoma that can arise from a low-grade, well-differentiated liposarcoma that can progress overtime into a dedifferentiated liposarcoma. Treatment includes surgical resection or removal of the tumor.
Dedifferentiated liposarcoma is the least common subtype of liposarcoma and usually arises from a well-differentiated liposarcoma. Progression occurs in 17 % of patients when well-differentiated liposarcoma is located in the retroperitoneum and 6% of cases when well-differentiated liposarcoma is located in the extremities. Dedifferentiated liposarcoma has also been defined as an atypical liposarcoma that progresses or changes over the course of time with variable histologic grade. This is essentially a low grade liposarcoma mixed with a high grade spindle cell sarcoma. These tumors occur mostly in adults and tend to grow more aggressively than a low grade well-differentiated liposarcoma. They arise most commonly in the retroperitoneum.
Dedifferentiated liposarcoma is a malignant sarcoma that commonly occurs in the retroperitoneum, or the area in the back of the abdomen. 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. Without treatment, dedifferentiated liposarcomas can metastasize or spread throughout the body, with the lungs, liver, and bones being the most common sites. Several risk factors include location and size of the sarcoma, and mitotic count.
Radiographic imaging is used to help form a diagnosis. These include X-Ray, MRI, CT and Bone Scans.
An example of an MRI is shown.
The treatment of dedifferentiated liposarcoma includes surgical excision through wide or radical resections. 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. Additionally, radiation and/or chemotherapy is recommended as adjuvant treatment. Early diagnosis and treatment is beneficial, as there is a 15%-20% chance of metastasis without early and effective treatment.
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.
Radiation is a treatment option for some cancers. Radiation therapy is a localized treatment that utilizes high-energy particles or waves to kill cancerous cells. Because radiation therapy is a localized treatment, it only affects the area in which it is set to target and therefore eliminates the risks of damaging healthy cells throughout the body. Not only is it used to treat cancer, but it can also decrease the chances of the cancer from recurring. Lastly, radiation may be used in conjunction with other treatments, such as surgery or chemotherapy, to treat cancers.
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.