liposarcoma - consisting of mezenhialnyh cancer cells, mainly affects older men.Liposarcoma tumors are large enough, are often formed on the inner thigh, buttocks, retroperitoneal fat and have located outside the main focus of many smaller satellites.Of all known soft tissue sarcomas liposarcoma most common (15%), the frequency of occurrence of three cases per 1 million population.Most often this tumor develops in the male population, after forty years, geo-referenced to any area not found.
Types liposarcoma : myxoid liposarcoma (fetal lipoma), highly differentiated liposarcoma (sclerosing lipoma, polymorphonuclear fibroadenoma, polymorphonuclear lipoma), cell round liposarcoma (lipoblasticheskaya sarcoma, infiltrative-fetal-cell lipoma, adenoid lipoma), polymorphous liposarcoma (lipotsitarnaya sarcoma,liposarcoma).In addition to these forms can be observed non-differentiated liposarcoma, and mixed form containing a structure common to all types of liposarcoma
liposarcoma - causes of
reasons for the development of the tumors studied to date is not enough.It is well established that in some cases the tumor starts its development on the background of benign tumors like lipoma and neurofibroma, suggesting its association with such a disease like neurofibromatosis.In addition, there were cases of Kaposi's relationship and radiation therapy, exposure to asbestos prior to mechanical trauma.Despite the discovery of tissue liposarcoma estrogen-positive retsiptorov role in its development of corticosteroids has not been proved.
liposarcoma usually grow very slowly and rarely metastasize.There have been isolated cases of documented metastases skid blood by the bone marrow, lungs and liver
liposarcoma - symptoms and signs
size liposarcoma often no more than twenty centimeters.It usually affects the proximal lower extremities, Located in striated muscle, in some cases, localized in subcutaneous fat.Groin, calves, buttocks and retroperitoneal space tumor affects more rarely, in exceptional cases, it can be seen on the genital lips, hands, feet, spermatic cord and in the mouth.
Its structure resembles liposarcoma immature embryonic or fetal adipose tissue.Consisting of fetal tissue liposarcoma grayish color with a burgundy-red veins, it has a gelatinous texture and a thin translucent capsule.Other types of liposarcoma capsule poorly expressed, they are yellow, thicker consistency, with strands of connective tissue and foci of hemorrhage and necrosis.
On palpation determined fairly large (20 cm) round single node, uneven density, irregular shapes, elastic-elastic or solid consistency.During the probing both hands neoplasm limbs can move only in the transverse direction, and in the case of bone ingrowth into the underlying tumor remains stationary.
Pronounced pain is a hallmark of tumors sprouting bone or compressing the nerves (about 20%).In the later stages of sarcoma raises the local temperature and the temperature of the body, the skin over the tumor bluish-purplish, ulcerated subcutaneous veins and expanded.If the tumor leads to blocking or clogging of nerves, veins and large arteries, the patient has the appropriate symptoms - deep vein thrombosis, phlebitis, paralysis and paresis, swelling, or limb ischemia.Symptoms in advanced stages of the disease is as follows: increasing weakness, intoxication, weight loss, anemia and fever.
Most often any symptoms in liposarcoma is not observed in only about 20% of patients may present certain signs that indicate the presence of disease.When a tumor the size of a small patient sometimes can bother some pain in the area of the development of tumors.If liposarcoma develop in the abdomen, the person may feel strange compression of internal organs.
diagnosis of liposarcoma established on the basis of histological and magnetic resonance imaging.Held incisional, excisional and punch biopsy tissue.To confirm or rule out metastasis performed CT, X-ray and ultrasound diagnostics.The differential diagnosis must perform the following diseases: sleroziruyuschaya fibrosarcoma, hibernoma, lipoma
Liposarokma - treatment
liposarokomy Treatment can be integrated or combined.Self-surgical treatment is carried out only for the treatment of low-grade tumors with a prerequisite for the possibility of the radical intervention.
principles of surgical treatment: the tumor is removed along with the place from which the biopsy was taken;liposarcoma removed without exposure of the tumor itself;removing borders are marked with special metal staples;in the case of inconclusive removed tumor is shown a second operation (reoperation).
main types of surgery:
• Radical conserving surgery.This kind of radical intervention carried out at deep-seated vysokozlokachestvennyh sarcomas.The tumor and surrounding tissue is removed along with the surrounding muscles and fascia
• wide excision.This intervention is indicated for superficial low-grade liposarcoma.The tumor is removed along with the pseudocapsule, departing from the edge of about five centimeters
• disarticulation and limb amputation.Conducting these types of radical intervention is indicated only in case of a massive tumor destruction when radical conserving surgery is not possible
and after preoperative radiation therapy is conducted, which is also used for the treatment of distant metastasis and local recurrence.
For large unresectable tumors is applied chemotherapy (dacarbazine, bleomycin, dactinomycin, vincristine, cyclophosphamide, doxorubicin).In addition, the chemotherapeutic treatment is applied in the presence of metastases and tumors vysokozlokachestvennyh.Often chemotherapy is carried out in combination with radiation therapy and / or surgery.
forecast liposarcoma not very optimistic.Five-year survival is celebrated on the border 50% ten-year survival rate - 30%.Slightly higher life expectancy at myxoid tumors and highly differentiated variants.It also depends on the place and localization of cancer: the liposarcoma of the lower extremities five-year survival is about 70%, while the retroperitoneal liposarcoma no more than 40%.Children in all types of liposarcoma five-year survival of about 90%.