FAQ - Liposarcoma
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What doctor should I go to if I suspect I have liposarcoma?


I have looked online and keep reading that if you have a lipoma on the thigh it is more likely (I know it's not a high chance) that the lipoma could be sarcoma. So what doctor is best to go to for that sort of thing? It is in the inguinal area. I went to the gynecologist and he said it is a lipoma and showed me one on his back. I hope it's nothing but after reading that the ones that are cancerous tend to be in the area where mine is...I want to get it checked out. Thanks!
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Isn't it possible for a lipoma to grow greatly?


Consider the woman who has had a huge tumor removed from her body that was more than one hundred pounds...does a tumor that has grown large almost always have to be liposarcoma (in thigh)... or can it still be a lipoma?
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lipomas can grow to huge sizes ,  (+ info)

Why do we get cancer?


I was diagnosed with liposarcoma in my right thigh (a rare malignant tumor -that arises in fat cells-) couple of years ago, six months after I had my first baby. When I asked several specialist about reasons they told me that no well-established causative factor has been identified for liposarcoma or several types of cancer in general. One even mentioned it was 'Just luck'.
What are your thoughts? What are your findings?
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Cancer is when the cells divide uncontrollable. The cell is missing a certain enzyme that tells the cell to stop dividing.

And Cancer can be passed down from gentics.

May God Bless and Im sorry for the situation your in.  (+ info)

What is adjuvant chemotherapy ...?


Its purpose, necessity or is it a precautionary thing.

Patient relative has had 3 surgeries for abdominal liposarcoma.
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Adjuvant therapy is given in addition to your primary treatment to enhance its effects.  (+ info)

Lipoma....Lump on back of thigh?


I have a lump (under the skin) on the back of my thigh. I have gotten these for several years. The lumps come and go. They are tender to touch and have a hard center (not movable) and the skin is red about an inch around. Just wondering if this could be Lipoma or liposarcoma.
Thanks Ellen, but I don't think that is it. I do not have small white pimples, and it is not on the surface of the skin. It is one solid lump under the skin on the back of my thigh.
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Quite a difference. No one here can tell you what these could be . . if it is a lipoma it would be benign if it is liposarcoma it is malignant (cancer). The only way to know is to have a biopsy done . . if it concerns you. You say you have basically ignored it for several years and that
they come and go . . and you have never had a doctor examine them? If they are benign . . no problem . . but if this is cancer . . than waiting several years could cost you your life. Go to a doctor to be on the safe side. Cancer is nothing to fool around with.  (+ info)

Help! Lipoma or Sarcoma?


This is a doctor's note on an outpatient education printout. What does this mean?
"patient is a 50 year old with a lipoma vs. liposarcoma FNA insufficient for diagnosis, query need for core biopsies of removal of lipoma (esp. given CT read stating it is possible a sarcoma)."

This patient has a lump on his neck and on his arm. Not sure which one this is referring to. Thank you for your time.
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A lipoma is generally a benign tumor located in fatty tissue. A liposarcoma is a malignant tumor in fatty tissue.

So basically his note is a recommendation to perform a core biopsy (remove a sample) to determine if its a lipoma (harmless) or a potential sarcoma (a malignant tumor). Evidently the CT (cat scan) was inconclusive and requires further investigation.

Since there are two lumps - they will probably do the biopsy on either both locations OR the location that the CT was performed upon.

Forgot to mention the FNA stands for fine needle aspiration. This means they most like tried to take a few cells out via a thin needle inserted into the "lump". The results along with the CT were inconclusive - a larger sample is needed for a complete diagnosis.  (+ info)

I received my ultrasound results....?


Okay, as the story continues...

I had a liposarcoma in 99/00; this was a high grade liposarcoma (something I've failed to mention in past questions) located in my abdominal area.

I had found some lumps in my legs and finally got the results of the ultrasound that I had done.

In regards to the doctors that I have been seeing, NONE of them have ever treated anyone, and some never even known anyone with a liposarcoma. The guy that did my ultrasound on the lumps in my legs has only done ultrasounds in the legs to look for veins, varicose veins, or blocked veins. He said that he had never looked for lumps in the legs.

So, here is what the report says...

Clinical Indication: history liposarcoma lumps lower extremity, question varicosities versus soft tissue masses.

FINDINGS: There is one lump right lower extremity which appears to be caused by a varicose vein. There are three lumps lower left extremity. 5mm lump appears to be solid and does not represent a varicosity. There is also a 2.7 mm lump left lower extremity anteriorly which appears to be a vessel. 5 mm lump in the left lower extremity is the only soft tissue mass which could represent neoplasm. There does appear to be a rent in the sarcolemma adjacent to that lump and this may be simply represent herniated muscle. If there is clinical concern for metastases fine needle aspiration could be performed.
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I know that a fine needle aspiration is not a recommendation for my type of cancer. I feel that I need to have my leg opened up and a exploratory surgery be done.
Because of my experience of being misdiagnosed for so many years to begin with, I will not allow ANY lump go unchecked in my body. If it's a lump that can be removed, I will fight until it is removed.

I'm hoping that BELLYDOC will see this!! I appreciate the answers that you have given me so far!
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Message: received!

The bottom line is that if you want this lump excised for pathology, even if it's only 5 mm (tiny), it should come out just for your peace of mind. I'd do it without blinking, as would probably every surgeon I can think of. There is no reason to leave you feeling anxious.

The fact that you're this far out from the original surgery and it was called "high grade" at the time, is a great surgical result. It really starts to look like there was none left behind.

I'm not one that's fond of the word "cure" when it comes to cancer, but a few more years and you really won't have any other ways to describe it.

In removing a mass from your thigh that's as small as you describe, there may actually be a little challenge to it. Oddly enough, my experience is that once the overlying skin is opened, the sense of a discrete mass which can be felt becomes much less distinct. At times, I'll actually use the help of the radiologists who will place a needle into the mass by ultrasound, in order to insure that I get the thing in the specimen that goes to the lab. This is called a needle localized biopsy.

The general rule with making incisions in order to obtain biopsy for possible sarcoma is to plan ahead. If the biopsy result is positive, usually one has to go back to excise more tissue and make sure that all of it is gone. This has to include the previous biopsy incision, just in case tumor cells were wiped off on the walls of the incision when it was opened. The entire incision needs to be removed with an oval of skin around it. All of the tissue that was disturbed by the previoius biopsy has to go. The original site, along with a margin of healthy tissue needs to be removed.

For this reason, it's my practice to place a couple of metal clips into the tissue around where I biopsy for suspected sarcoma. That way, the radiologist can use xray to pin-point the location and place a needle into it.

A positive biopsy for sarcoma is quite rare, and I have to say that even in those cases where I felt CERTAIN, I've only been right ONCE. Everyone else has had benign biopsies. The only other times I've come across sarcomas that weren't already diagnosed, it was a surprise... much like yours, which sounds like it took some time to figure out.

Personally, I wouldn't be too worried about a tiny lump in the thigh, even given the aggressive nature of your initial tumor. The probability that it relates to the previous tumor seems low to me.

I completely understand and support your drive to get a solid answer, though, and whether it's a negative biopsy or a positive one necessitating re-exision, I think you should remain as alert to your own body as you are now, for at least a few more years.

I hope you'll keep me informed as to what happens, because I have no doubt that the lump is soon to be gone. ;)

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Cancerous X-ray pictures of the lungs???? Please help!?


My mother had CT scan & x-rays done today and she will not get the results in until the 28th of this month. I was hoping that someone out there educated would be able to tell me something about my mother's x-rays. Her doctor said that her liposarcoma has spreaded into her lungs. She had the liposarcoma on her back and the doctor removed it may 8th 2008. We are hoping that he has misdiagnosed her. I've been reading up on lung nodules and how most of them aren't cancerous and how the appearance looks in a x-ray which is white shadowy looking spots. I'm no doctor so I'm not 100% sure of anything but, to me it looks like it could be lung nodules instead of liposarcoma. It's driving the family crazy so if anyone can help then please give us your two cents. There are six links below that I will send. Please click on all six of them to see six different shots of her chest and lungs. Please let me know as soon as possible. We are about to go crazy! Thanks!

http://i220.photobucket.com/albums/dd223/TEXAS_STAR92/0027.jpg
http://i220.photobucket.com/albums/dd223/TEXAS_STAR92/0094.jpg
http://i220.photobucket.com/albums/dd223/TEXAS_STAR92/0159.jpg
http://i220.photobucket.com/albums/dd223/TEXAS_STAR92/0224.jpg
http://i220.photobucket.com/albums/dd223/TEXAS_STAR92/0263.jpg
http://i220.photobucket.com/albums/dd223/TEXAS_STAR92/0276.jpg
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Well I hope and pray they are wrong too but because she's had cancer already and these nodules are there now and weren't before it could very well be it has spread.

That is why I agree that you should push for faster results as if it IS cancer it's moved fast and you want to get her on the right treatment to beat it back asap.

Always stay hopeful as many people beat back cancer and survive many, many years, even if it's something they can't beat back entirely.

But she should be getting biospied immediately to make sure.

Keep hoping for the best but be prepared for the worst too....ie chemo or radiation.

Why are results taking so long? If you have the xrays, let an oncologist look at them and see what they recommend.  (+ info)

I got my CT Scan Results, can anyone help interpret this?


I finally was able to get a CT scan as a follow up for a liposarcoma that I had in 2000. Here is the radiology report:

CT chest, abdomen and pelvis
Findings: Lungs are clear. Scattered thin walled lucent cysts in the lung bilaterally. No pleural or pericardial fluid or mediastinal abnormality.
The liver is prominent and mildly fatty with caudal edge of the liver extending below the lower pole of the right kidney and transverse dimension of the liver from right to left measuring about 28 cm. Several scattered small hypo densities are noted in the liver which are too small to characterize including one on image #160 in the left lobe and one in the posterior right lobe on image #158 and another at age image#155 and also image #150. These are probably preexisting benign lesions or cysts.
The spleen, pancreas, adrenal glands and kidneys are unremarkable.
There is no intraabdominal mass or evidence of recurrent fatty tumor. Normal appendix. There is a small enhancing nodule in the right fundus of the uterus consistent with a fibroid. No pelvic mass or cyst. No ascites.
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I don't understand something... How can someone look at a picture and know right away that something is a cyst?
My problem with this is because I was misdiagnosed for 7 years before they finally removed the tumor that ended up being a liposarcoma. I know that liposarcomas like to go to the lungs, so the fact that there are "cysts" there really bugs me...
Any opinion would be appreciated.
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A contrast enhanced CT scan is quite good at telling the difference between a fluid filled item, a solid item that has the equivalent density and blood flow as fat, and a solid item that has lots of blood flow.

One of the simplest ways to tell the difference between the characteristics of various findings on a CT scan is to compare them to tissue or material of a known character. If, for example, a mass is found inside the abdomen, and it has about the same density or gray shade as the fat under the skin, then it's probably a fatty mass. If it's a brighter gray and looks more like the shade of the abdominal muscles, then it has a lot more blood flow and tissue density than fat... it's more like muscle.

This is a very simplistic explanation, but it's the first thing one notices about an unknown mass on a CT scan.

A more sophisticated way to make the determination is to actually read the "Hounsfield units" measurement at that given position. HU measures the density of an object based on how much it stops the x-rays used in the CT scanner. The result is obtained with nothing more than a couple of "point and click" choices on the computer.

Often, when CT scans are done, we actually get TWO or MORE scans in rapid succession. Sometimes we get one set of images, inject the contrast, and then get another set of images, and then sometimes we wait and get even more sets of images! These serial imagings are useful to detect the variation of blood flow in different tissues. Certain types of tumors have characteristic patterns of enhancement with IV contrast over time.

However, liposarcoma isn't one of them. You probably had a single CT series obtained with IV contrast, and probably oral contrast as well.

A large portion of radiology expertise is really familiarity and pattern recognition. Having seen metastatic sarcoma to the lung, the radiologist just knows what it looks like. Cysts have a different appearance.

Cysts are generally fluid filled sacs with a wall that is made of living tissue. The living tissue has blood flow and shows up with enhancment on the CT scan. The fluid inside has a density basically equivalent to water and has no enhancement. If the radiologist saw something like that, they'd call it a cyst.

Radiologists are generally scared to "under-read". If the radiologist is aware that you had a history of liposarcoma (and the report suggests that they ARE), they know that you have a risk of metastatic recurrences that could occur at the original site, in the lung or even in bone. They'd LOOK for that. If they saw anything that was questionable, they'd put the onus of responsibility back on the surgeon to make a genuine determination.

They'd use terminology such as "masses observed in the lung cannot be fully characterized, biopsy recommended", or "lesions of unknown significance found in the lung fields, clinical correlation required." These would be signals to the surgeon that the radiologist is not willing to be responsible for non-intervention.

In your case, the fact that the radiologist is being clear in their CT diagnosis is very reassuring.

Sarcomas are best characterized in terms of "grade". They will be referred to as "high grade" or "low grade" depending on the microscopic evaluation. This helps predict their behavior over time. Sarcomas tend to recur at the original site because it's often difficult to get the whole thing. Less commonly, they crop up in distant sites, but when they do, it's often because they are high grade, aggressive cancers.

You appear to have been cancer free for over 7 years. You're doing really well! Congratulations on kicking butt on some bad disease. :)

Edit:

I was going to refer you to a recent liposarcoma question I answered for some further info, but...

IT WAS YOUR QUESTION! :D

I guess this is the internet equivalent of "continuity of care" !  (+ info)

A question about Lipoma?


About a year ago, I had a huge fatty deposit almost the size of a baseball taken out of my right leg. They analyzed it and said it was a lipoma

Right now I have a lot of Lipomas (14 - 15 of them, this number includes the big one, and the tiny ones - this is way more than I had when I did the surgery more than a year ago). However only one of them is a big one, and the other smaller ones vary in size.

Only the smallest ones hurt, as it gets bigger it hurts less, and the biggest one don't hurt - Is this inconsistent with Liposarcoma?

However, I do notice that some of the smaller lipomas are very close to each other, for example I have 2 very small ones located right next to each other, on top of tendon in my right leg (the tendon that connects the leg to the pelvis), is this consistent with liposarcoma?

I had it checked out by a family doctor, and he referred me to surgery. He said he thinks its just lipoma, because they are soft, but I better double check with the surgeon to make sure. Although he didn't really check carefully, he just touched 1 of them for like a split second.

So I've made an appointment to get it checked out, but the next available one is in 3 weeks, so I'm just wondering what do you people with a medical background think :)
Also, if you think it's liposarcoma, could you tell me, I won't lose any sleep over it
btw thanks in advance for answers
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sounds like more lipomas. The tendency to get these is hereditary. It is very rare for a lipoma to become liposarcoma.  (+ info)

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