Abstract
Atypical lipomatous tumor (ALT) has been defined as a well-differentiated liposarcoma exhibiting a higher frequency of a local recurrence after surgical resection. ALT is mainly classified into deep type and superficial type. Compared with deep type ALT, superficial type ALT is rarely observed. One of the most important issues is that little has been known about superficial type ALT and it is not easy to predict the presence of superficial type ALT before surgical resection. To clarify the clinical manifestations of superficial type ALT, we examined 15 cases with superficial type ALT and 118 cases with benign lipoma, and analyzed their differences in clinical characteristics and the findings of MRI test. In clinical characteristics, the tumor size of superficial type ALT was significantly greater than that of benign lipoma, and superficial type ALT showed a significantly higher frequency of the tumor size of more than 4 cm. Superficial type ALT exhibited poor tumor mobility and hardness with elastic soft. In addition, a significantly higher frequency of tumor location of superficial type ALT was observed in extremities. Among tumor sites at the trunk, buttocks, and shoulder were high frequent location in superficial type ALT. In an MRI examination, superficial type ALT exhibited a significantly higher frequency of the septal structures compared with benign lipoma. The combinations of clinical characteristics, including physical examinations, MRI, and histological examinations, are helpful for the diagnosis of superficial type ALT.
Highlights
Adipose tissue is one of the sources of stem cells, which are derived from the embryonic mesenchyme
We summarized the clinical characteristics of atypical lipomatous tumor (ALT) and lipoma in our study shown in Tables 1, 2
Previous studies have shown that the findings of MRI are useful tools to distinguish deep type ALT from benign lipoma
Summary
Adipose tissue is one of the sources of stem cells, which are derived from the embryonic mesenchyme. Adipose tissue sometimes develops into adipocytic tumors, such as lipoma, which are commonly seen in dermatological clinics. Evans reported that a well-differentiated type of liposarcoma showed high frequencies of a local recurrence and metastasis. They proposed this tumor as a novel entity of adipocytederived tumors, namely, atypical lipomatous tumor (ALT) [2]. There is no clear definition of clinical subtypes, ALT is classified into two subtypes—superficial type, such as a fat-layer origin, and deep type, such as a muscle-layer or a retroperitoneum origin—in accordance with the Atypical Lipomatous Tumor occurrence sites, as previously described [3]. The detailed clinical characteristics of superficial type ALT remain unclear
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