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Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years.
[pleomorphic liposarcoma]
Sixty
-
one
cases
of
neoplasms
composed
wholly
or
in
part
of
atypical
lipomatous
tumor
were
reviewed
.
Minimum
follow-up
was
10
years
.
The
cases
were
divided
into
4
groups
based
on
the
findings
in
the
initial
excision
specimen
:
conventional
atypical
lipomatous
tumor
(
n
=
15
)
,
cellular
atypical
lipomatous
tumor
(
n
=
21
)
,
dedifferentiated
liposarcoma
(
n
=
24
)
,
and
atypical
lipomatous
tumor
with
a
pleomorphic
liposarcoma
-like
component
(
n
=
1
)
.
The
term
"
cellular
atypical
lipomatous
tumor
"
was
applied
to
atypical
lipomatous
tumors
having
areas
of
increased
cellularity
that
when
non-lipogenic
lacked
the
5
mitotic
figures
per
10
high
-power
fields
(
maximal
rate
)
required
for
a
dedifferentiated
component
and
when
lipogenic
fell
short
of
being
truly
pleomorphic
liposarcoma
-like
.
Myxoid
regions
within
this
spectrum
sometimes
had
prominent
or
even
plexiform
vascularity
,
creating
a
resemblance
to
myxoid
liposarcoma
especially
when
interspersed
small
fat
cells
were
present
.
The
most
important
prognostic
factor
was
tumor
location
,
as
none
of
the
12
patients
with
a
subcutaneous
or
intramuscular
neoplasm
died
of
tumor
.
Among
the
49
patients
with
neoplasms
of
central
body
sites
(
mostly
retroperitoneum
)
,
those
with
dedifferentiated
liposarcoma
had
significantly
shorter
survival
(
median
77
mo
)
than
those
with
cellular
(
median
142
mo
)
or
conventional
(
median
209
mo
)
atypical
lipomatous
tumor
,
whereas
there
was
no
statistically
significant
difference
between
the
latter
2
categories
.
Patients
with
atypical
lipomatous
tumor
(
either
cellular
or
conventional
)
in
central
body
sites
had
significantly
shorter
survival
if
the
tumor
transformed
into
dedifferentiated
liposarcoma
in
recurrence
,
and
,
conversely
,
those
with
central
body
site
dedifferentiated
liposarcoma
had
significantly
longer
survival
if
it
recurred
as
atypical
lipomatous
tumor
.
Metastasis
(
7
cases
)
occurred
only
when
the
initial
specimen
or
a
recurrence
demonstrated
dedifferentiated
liposarcoma
.
Diseases
Validation
Diseases presenting
"cellular atypical lipomatous tumor"
symptom
pleomorphic liposarcoma
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