title: Atypical lipomatous masses of the extremities: outcome of surgical treatment.
abstract: Atypical lipomatous tumors occur predominantly in middle-aged patients and often present as painless, slow-growing masses in the extremities. The clinical outcomes of surgically treated superficial or deep atypical lipomas of the extremities were reviewed. Thirty-one patients were included in this study. There were 16 men and 15 women, with an average age of 57 years (range, 32-87 years). The mean followup was 7 years (range, 1-28.8 years). Twenty-five tumors occurred in the lower extremity and six in the upper extremity. Sixteen patients (52%) had a recurrence at an average of 4.7 years after resection. Twelve (39%) patients required additional surgical procedures to treat their tumor. Occurrence of a deep lesion and positive margins at the time of the initial surgery correlated closely with the rate of recurrence and need for additional surgical treatment. Dedifferentiation to high-grade liposarcoma developed in four (13%) patients. Atypical lipomas have a high propensity for local recurrence and a potential for malignant dedifferentiation. Patients with atypical lipomas require careful evaluation, complete surgical excision when possible, and close clinical followup extending beyond 5 years.
authors.affiliation: Orthopaedic Oncology Service, Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
authors.forename: Tamara D
authors.initials: TD
authors.lastname: Rozental
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Khoury
authors.forename: Rakesh
authors.initials: R
authors.lastname: Donthineni-Rao
authors.forename: Richard D
authors.initials: RD
authors.lastname: Lackman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D016009:Chi-Square Distribution; D005121:Extremities; D005260:Female; D006801:Humans; D008068:Lipomatosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome