Can a liposarcoma metastasize?

A liposarcoma can metastasize. This involves the detachment of small nests of tumor cells that can enter the bloodstream and thus be carried throughout the body and can form metastases. Liposarcomas metastasize particularly frequently into the lungs, but bones, liver, peritoneum, diaphragm and the pericardium can also be affected. Small metastases often cannot be detected by CT or MRI.

Diagnosis

If tissue proliferation is noticed, imaging procedures such as computed tomography (CT), magnetic resonance imaging (MRI), angiography or scintigraphy are first used to assess the situation. They are intended to show how large the tumor already is and how it relates to the surrounding structures (vessels, nerves, organs), so that it is possible to estimate the chances of removal. In addition, they will check whether metastases have already formed in other regions.

If the diagnosis is to be confirmed, a biopsy with subsequent histopathological examination is usually necessary. Depending on the extent of tissue proliferation, only part of the node or even the entire node is removed. After removal, the node is cut into fine layers, which are then examined under a microscope by an experienced pathologist.In addition to the histological examination, an immunohistochemical examination is performed, which helps to distinguish the alleged liposarcoma from other sarcomas.

Different staining techniques are applied. Well differentiated liposarcomas express vimentin and S-100. If only vimentin is expressed, this is a sign of a poorly differentiated tumor.

The doctor can use an ultrasound of the abdominal cavity to assess whether a liposarcoma has formed there and whether metastases have developed. Metastases usually affect the lungs, but can also occur on the liver, diaphragm, peritoneum or pericardium. Liposarcomas can be easily visualized and diagnosed by ultrasound, but more precise information about the malignancy can only be provided by a histological examination by the pathologist.

An MRI should already have been performed before taking a tissue sample (biopsy) for histological examination of the tumor. Magnetic resonance imaging (MRI) is a high-resolution imaging procedure that is used to accurately assess the spread of the tumor. It can also be determined whether blood vessels have already been affected.

However, a final diagnosis can only be made by examining a biopsy. If the location of the tumor allows it, it is best to have it completely removed surgically. This is also the best prevention against a recurrence of the tumor.

A sufficient safety margin must be considered so that the tumor cells are not spread to other tissues during the operation and can continue to grow there. If removal is not possible because the tumor has already infiltrated other areas (i.e. grown into them) or the dedifferentiation of the liposarcoma is too far advanced, radiation therapy can also be performed. Even though liposarcoma is considered the most radiation-sensitive sarcoma, scientific studies have so far not shown any increase in survival time with radiation treatment. If metastases have already formed, chemotherapy will most likely follow, although this is still undergoing research.