Lipomas

Recurrence After Marginal Excision for Atypical Lipomatous Tumors Versus Lipomas of the Extremities

This study reviewed the medical records of 90 patients with lipomas (47 patients) and atypical lipomatous tumors (ALT)/well-differentiated liposarcomas (WDL) (43 patients) of the extremities treated from 2006 to 2012. All patients had preoperative biopsy and postoperative histologic analysis of the tumors; surgical margins were marginal in all cases. Histologic sections of the tissue blocks from the excised specimens were re-reviewed for all patients; a consensus with postoperative histologic analysis was confirmed. Molecular chromosome analysis was performed on fluorescence in situ hybridization in tissue sections from the tissue blocks in all cases for the purpose of this study; a ratio greater than 2 was considered to represent murine double-minute 2 (MDM2) amplification consistent with a diagnosis of ALT/WDL. Mean follow-up was 52 months (range, 14-96 months). Local recurrence and metastasis rates and the relationship of patient age and sex with tumor size and location were evaluated. None of the patients with lipomas experienced local recurrence compared with 6 patients (13.9%) with ALT/WDL who experienced local recurrence within a mean of 48 months (range, 33-96 months); this difference was statistically significant. None of the patients in either group experienced metastasis prior to the study period. Local recurrence did not correlate statistically with patient age or sex, or with tumor size or location. [Orthopedics. 2016; 39(4):e610-e614.].

[Benign soft tissue tumors in orthopedics]

For the most part soft tissue tumors are benign. However, the clinical presentation, including radiological aspects, is not always clear. Therefore, a biopsy is necessary in some cases to detect malignant tumors at an early stage. The course of even benign tumors is sometimes complicated. A not insignificant group of local, aggressive or intermediary tumors tend to recur and in exceptional cases can be fatal. Benign soft tissue tumors are subdivided according to the current WHO classification from 2002. They are classified by the tissue they mimick. In clinical practice they are additionally grouped according to aggressiveness. Some benign soft tissue tumors occur in the context of a syndrome, leading to multiple tumors. In these cases there is the threat of a tumor becoming malignant (neurofibromatosis, Maffucci syndrome).