Liposarcoma - Symptoms and causes

Liposarcoma is a rare type of cancer that originates in your fat cells. As a form of soft tissue sarcoma, it develops from connective tissues, which include fat, muscles, nerves, and blood vessels. 

The cancerous tumors in liposarcoma are made of fat cells (lipocytes) and can grow almost anywhere in the body. Still, they most commonly occur in the muscles of the limbs, particularly the thigh, or in the abdomen.

Symptoms of Liposarcoma

• A growing lump of tissue under the skin
• Swelling or numbness in the affected area
• Pain
• Weakness of the limb
• Abdominal pain or cramping
• Swelling or an increase in belly size
• Feeling full quickly when eating
• Constipation
• Blood in the stool
• Nausea and vomiting
• Fatigue
• Fever
• Unintentional weight loss

Classification of Liposarcoma

Liposarcoma is classified into several subtypes based on the microscopic appearance of the cancer cells. This classification helps doctors determine the tumor's likely behavior and the most effective course of treatment. The types are:

• Well-differentiated Liposarcoma. This is the most common subtype. It is a low-grade cancer, meaning its cells resemble normal fat cells & tend to grow slowly. These tumors are least likely to spread to other parts of the body. When this type develops in the abdomen, it's called an atypical lipomatous tumor.
• Myxoid Liposarcoma. This is the second most common subtype. It is considered an intermediate-grade cancer. These tumors often develop in the thigh muscles and contain a network of blood vessels.
• Pleomorphic Liposarcoma. This is the rarest and most aggressive subtype. It is a high-grade cancer, meaning the cells look very abnormal and multiply rapidly. It has a high risk of spreading to other parts of the body (metastasizing).
• Dedifferentiated Liposarcoma. This type is a combination of a low-grade (well-differentiated) tumor and a high-grade tumor. It begins as a well-differentiated liposarcoma but then has areas that transform into a more aggressive, faster-growing cancer.

What Causes Liposarcoma?

The cancer develops when fat cells undergo changes, or mutations, in their DNA. These mutations disrupt the normal instructions that control cell growth and death, leading to an uncontrolled multiplication of abnormal cells that accumulate to form a tumor. 

While the specific trigger for these genetic changes is unknown, some factors can escalate the risk of developing soft tissue sarcomas like liposarcoma. These risk factors include having certain inherited genetic syndromes, such as Li-Fraumeni syndrome and neurofibromatosis, a history of receiving radiation therapy for a previous cancer, or long-term exposure to specific industrial chemicals.

Diagnosis of Liposarcoma

Initial Examination

A doctor will perform a physical check to assess the lump or area of swelling and discuss your personal and family medical history.

Imaging Tests

To get a detailed look at the tumor's size, location, and relationship to surrounding tissues, one or more of the following imaging tests may be used:

• X-rays provide a basic image of the affected area.
• Computed Tomography (CT) scans create detailed, cross-sectional images of the body.
• Magnetic Resonance Imaging (MRI) uses magnets and radio waves to produce a detailed image of soft tissues, making it particularly useful for viewing tumors in the arms and legs.
• Positron Emission Tomography (PET) scans can help determine if the cancer has metastasize to other parts of the body.

Biopsy

This procedure involves taking a small sample of the tumor tissue for examination in a laboratory. There are two main methods:

• Core needle biopsy: A doctor inserts a long, thin needle past the skin to extract a small core of tissue from the tumor.
• Surgical biopsy: A surgeon makes an opening to remove either a piece of the tumor (incisional biopsy) or the entire tumor (excisional biopsy).

Laboratory Analysis

The tissue sample from the biopsy is sent to a pathologist. They examine the cells under a microscope to confirm that it is liposarcoma and identify its specific subtype. Advanced lab tests may also be performed on the tumor cells to look for specific genetic mutations, which can help guide treatment decisions.

Treatment for Liposarcoma

The treatment for liposarcoma is tailored to the individual and depends on factors like the tumor's subtype, size, location, and whether it has spread. The primary goal is to eleminate the cancer completely while also preserving as much function as possible.

Surgery

• This is the most common and primary treatment for liposarcoma. The goal is to remove the whole tumor along with some margin of healthy tissue that surround it to ensure no cancer cells are left behind.
• For tumors in the arms or legs, surgeons perform limb-sparing surgery whenever possible to avoid amputation.
• If a tumor is large or located near critical organs, other treatments may be used first to shrink it and make the surgery safer and more effective.

Radiation Therapy

• This treatment uses high-energy beams, such as X-rays or protons, to kill cancer cells.
• It may be administered before surgery (neoadjuvant) to shrink the size of the tumor, making it efficient to remove completely.
• It can also be used during surgery (intraoperative) to deliver a direct dose of radiation to the area after the tumor is removed.
• It is often used after surgery (adjuvant) to destroy any remaining cancer cells & reduce the risk of the cancer returning.

Systemic Therapies

These treatments use medications to destroy cancer cells throughout the body and are typically used for liposarcoma that has spread or cannot be removed surgically.

• Chemotherapy: This involves using powerful medications that are effective at killing rapidly dividing cells, including cancer cells. It can be administered through a vein (intravenously) or as a pill.
• Targeted Therapy: These are newer drugs that target specific weaknesses or abnormalities present within cancer cells. By blocking these targets, the medications can cause the cancer cells to die.
• Immunotherapy: This type of treatment saves the body's own immune system to find & fight cancer cells more effectively.

Living with Liposarcoma 

Consistent Follow-Up Care

• Regular Appointments: You will need to attend follow-up appointments with your oncology team. The frequency of these visits will be highest in the first few years after treatment and will gradually decrease over time.
• Imaging Scans: Expect to undergo periodic imaging tests, such as MRI or CT scans, of the original tumor site and your chest. These scans are crucial for monitoring for any signs of the cancer returning (recurrence) or spreading.

Rehabilitation and Physical Health

• Physical Therapy: If surgery affected a limb, physical therapy is essential to help you regain strength, flexibility, and a full range of motion.
• Occupational Therapy: An occupational therapist can help you find new ways to perform daily activities, such as dressing, bathing, and working, especially if you have long-term physical limitations.
• Managing Lymphedema: If lymph nodes were removed or affected by treatment, you may be at risk for lymphedema (swelling). Your care team can provide strategies to manage or reduce this risk, such as specialized exercises or compression garments.

Emotional and Mental Well-being

• Seek Support: Connecting with support groups, either in person or online, can be incredibly helpful. Sharing your experience with others who have undergone a similar diagnosis can help reduce feelings of isolation.
• Professional Counseling: A cancer diagnosis and its treatment can be emotionally challenging. Speaking with a therapist or counselor can provide you with coping strategies for anxiety, fear, and stress.
• Communicate Openly: Maintain an open dialogue with your doctors, nurses, and family about any physical or emotional challenges you are facing.

Outlook and Prognosis

The long-term outlook for someone with liposarcoma varies significantly and depends on several factors, including the tumor's specific subtype, its grade (how aggressive the cells are), its size and location, and whether it was removed entirely with surgery. 

Low-grade tumors that are fully removed have a very good prognosis, while high-grade or advanced cancers present more challenges. Your doctor is the best resource for information about your specific situation.

Sterling Hospital is Your Partner in Health Across Gujarat

At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to a healthier and brighter life. We've got you if you are looking for the best oncologist in ​​Ahmedabad (Gurukul) & (Sindhu Bhavan), cancer hospital in Vadodara (Bhayli & Race Course Road), or Rajkot. 

With considerable years of experience, we have built a team of the best oncologists in these regions to provide you with premium treatment and the best results. Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier future.