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| == Pathophysiology ==
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| Liposarcoma usually presents as a painless tumor in any part of the body. It is the second most common type of soft tissue sarcoma.It is usually 5 types and have got poor prognosis.
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| == Causes ==
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| The etiology of liposarcoma is unknown. However genetic and enviornmental factors are associated with liposarcoma.
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| == Differentiating Liposarcoma from other Diseases ==
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| Liposarcoma must be differentiated from other diseases that cause a painless, growing [[mass]] such as spindle cell [[lipoma]], [[neurofibroma]], [[dermatofibrosarcoma]] protuberans, and malignant peripheral nerve sheath tumor.
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| == Epidemiology and Demographics ==
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| Liposarcoma are the second most common type of soft tissue sarcoma in adults. The annual incidence is 0.25 cases per 100,000 population. Men are more affected than women and it is mostly seen in elderly and has got poor prognosis.
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| == Risk Factors ==
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| Risk factors of liposarcoma includes chemical carcinogen, genetic disorders, radiation and immunodeficiency. These increases the risk of liposarcoma in general population.
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| == Natural History, Complications and Prognosis ==
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| Liposarcoma may have different clinical presentations depending on the location of the [[mass]], being the lower [[extremities]] the most common area involved. [[Metastasis]] is the most important aspect to assess in the [[prognosis]] of the disease, but the mass may compress adjacent structures causing different clinical manifestations. The prognosis will depend on the [[histopathological]] subtype, being the well differentiated liposarcoma the subtype with the best [[prognosis]], and the pleomorphic liposarcoma with the worst [[prognosis]].
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| == Diagnosis ==
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| === Staging ===
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| The staging for liposarcoma is based on the TNM classification, depending on the primary tumor, [[lymph node]] involvement, [[metastasis]] and the [[histological]] grade of the tumor.
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| === History and Symptoms ===
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| Liposarcomas usually present as a growing [[mass]], not associated with [[pain]] and commonly located in the lower [[extremities]]. [[Retroperitoneal]] liposarcomas remain [[asymptomatic]] until they affect adjacent structures, causing [[pain]] or obstructive symptoms.
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| === Physical Examination ===
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| The physical examination findings will depend on the location of the liposarcoma, being the most common location the lower extremities. The main finding is a painless, slow growing, firm [[mass]] in one of the lower [[extremities]]. [[Retroperitoneal]] liposarcomas would have a late presentation and the physical examination findings include abdominal tenderness, [[abdominal distention]] and [[weight loss]].
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| === Laboratory Findings ===
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| A biopsy of the liposarcoma will give the definitive diagnosis and the histopathological subtype of liposarcoma. Other laboratory finding include anemia, due to GI bleeding, and increased [[BUN]] and [[creatinine]] in case of obstructive nephropathy.
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| === CT ===
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| CT imaging is one of the most important tests for the diagnosis of liposarcoma. CT should assess the size, location and depth of the liposarcoma, as well as the [[lymph node]] involvement and distant [[metastasis]]. CT findings can be correlated with the [[histopathological]] subtype.
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| === MRI ===
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| MRI is the imaging test of choice for the diagnosis of liposarcoma and should assess size, location and depth of the mass. MRI findings help to differentiate between the different subtypes of liposarcoma and help to assess distant [[metastasis]].
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| === Other Imaging Findings ===
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| Other diagnostic imaging for liposarcoma include a [[positron emission tomography]] (PET) scan.<ref name=NCCN>{{cite web | title = NCCN Guidelines for Patients - Soft Tissue Sarcoma | url =http://www.nccn.org/patients/guidelines/sarcoma/index.html#2 }}</ref>
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| === Other Diagnostic Studies ===
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| Genetic assessment is one of the other diagnostic test for liposarcoma.
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| == Treatment ==
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| === Medical Therapy ===
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| Treatment of liposarcoma is based on an integrated approach by a multidisciplinary team based on the medical history and physical examination, imaging, biopsy and genetic studies of the tumor. Chemotherapy, chemoradiation, immunotherapy and targeted therapy are the different types of medical therapy for liposarcoma.
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| === Surgery ===
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| Surgery is the primary treatment of liposarcoma. It may be integrated with chemotherapy and radiation therapy depending on the site, stage and recurrence of the tumors.
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| === Cost-Effectiveness of Therapy ===
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| === Future or Investigational Therapies ===
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| Current clinical trials of liposarcoma are promising and genetic basis of the disease is studied extensively to find an effective treatment for this disease.
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| ==References== | | ==References== |