What are the symptoms of liposarcoma?

Symptoms of Liposarcoma

Liposarcoma typically presents with a painless, gradually enlarging mass, often in the deep soft tissues of the extremities or retroperitoneum, with symptoms varying based on location and size of the tumor. 1

Common Presenting Symptoms

General Symptoms

• Painless mass or swelling (most common presentation) 1
• Pain (when present, may include night pain as a concerning "red flag") 1
• Abdominal distension (particularly in retroperitoneal liposarcomas) 2
• Gradual enlargement of the mass over time 1

Location-Specific Symptoms

• Extremity liposarcomas:

  • Palpable deep mass in the thigh (most common site) 3
  • Functional impairment of the affected limb 1
  • Pathological fracture (rare but possible) 1

• Retroperitoneal liposarcomas:

  • Abdominal distension (32% of cases) 2
  • Abdominal pain (28% of cases) 2
  • Asymptomatic until large size (44% of cases are discovered incidentally) 2
  • Compression symptoms affecting nearby organs 1

• Other locations:

  • Buttock tumors may present with inflammatory changes and ulceration in advanced cases 4
  • Lymph node involvement (uncommon except in certain subtypes like epithelioid variants) 1

Warning Signs Requiring Urgent Evaluation

• Deep-seated mass of any size 1
• Superficial mass larger than 5 cm 1
• Rapidly growing mass 1
• Mass associated with night pain 1
• Ulceration (sign of advanced disease) 4

Clinical Examination Findings

Physical examination should focus on:

• Size of the mass 1
• Consistency of the swelling 1
• Location and mobility of the mass 1
• Relationship of the mass to involved bone 1
• Assessment of regional lymph nodes 1
• Neurovascular examination of the affected area 1

Diagnostic Pitfalls

• A recent injury or trauma does not rule out liposarcoma and should not prevent appropriate diagnostic procedures 1
• Many patients (up to 44% in retroperitoneal cases) may be asymptomatic until the tumor reaches a significant size 2
• Symptoms may be present for an average of 3 months before diagnosis 2
• Liposarcomas can be mistaken for benign lipomas, especially when small 5

Histological Subtypes and Their Presentations

Different subtypes may present with varying clinical features:

• Well-differentiated liposarcomas: Often slow-growing, less aggressive 6, 3
• Myxoid/round cell liposarcomas: Intermediate aggressiveness 6, 3
• Dedifferentiated and pleomorphic liposarcomas: More aggressive, may present with more rapid growth and symptoms 6, 3

Early recognition of these symptoms and prompt referral to a sarcoma center for proper imaging and biopsy are essential for optimal outcomes, as delayed diagnosis can significantly impact treatment options and prognosis.