Soft tissue

Adipose tissue tumors


Pleomorphic liposarcoma

Topic Completed: 1 August 2012

Minor changes: 30 September 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Pleomorphic liposarcoma [title]

Vijay Shankar, M.D.
Page views in 2020: 10,189
Page views in 2021 to date: 9,427
Cite this page: Shankar V. Pleomorphic liposarcoma. website. Accessed October 21st, 2021.
Definition / general
  • Widespread high grade, pleomorphic tumor cells with some lipoblasts but no evidence of well differentiated liposarcoma
  • 5% of all liposarcomas
  • No gender preference
  • Median age 54 - 70 years; rare in childhood
  • Associated with radiation therapy or neurofibromatosis
  • Thigh (29%), internal trunk (21%), limb girdles (18%), upper extremity (16%), thoracoabdominal wall (10%)
  • Often deep seated or extracompartmental
Case reports
  • Wide local excision or amputation with postoperative radiotherapy (Am J Surg Pathol 2004;28:1257), also chemotherapy
  • Aggressive; often recurs locally (40%), metastasizes (40%), causes death (35%)
  • 5 year overall survival 60%
  • Poor prognostic factors: age 60+, truncal (central) location, deep, size > 5 cm, vascular invasion, incomplete excision (Am J Surg Pathol 2002;26:601)
Clinical images

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Pectoral wall mass

Gross description
  • Often large (median 8 - 10 cm, up to 23 cm), multinodular, white-yellow
  • Areas of hemorrhage and necrosis common
  • Usually deep (subfascial), often myxoid or necrotic areas
Microscopic (histologic) description
  • Well circumscribed but non-encapsulated with infiltrative borders
  • At least focal typical liposarcomatous areas
  • Pleomorphic cells cover > 65% of cut surface with MFH-like, round cell liposarcoma-like (without vascular network), spindle cell liposarcoma-like or epithelioid cells (Mod Pathol 1999;12:722)
  • Usually high grade with enlarged round to bizarre nuclei
  • Tumor necrosis common
  • Median 25 mitotic figures / 10 HPF
  • May have neutrophils within giant cells, hemangiopericytic foci, extra- and intracellular hyaline droplets
  • Epitheloid variant often confused with carcinoma
Microscopic (histologic) images

AFIP images

Lipoblasts present

Vacuolated lipoblasts

Myxoid stroma with markedly pleomorphic cells

Pleomorphic round cells

MFH-like areas

Contributed by Mark R. Wick, M.D.

Images hosted on other servers:

Pectoral wall

Cytology description
  • Pleomorphic spindle cells of high grade sarcoma with occasional lipoblasts
Positive stains
Electron microscopy description
  • Abundant coalescing lipid droplets, numerous cytoplasmic organelles
Molecular / cytogenetics description
  • Complex karyotype
  • Shares similar genomic imbalances with myxofibrosarcoma (Lab Invest 2005;85:176)
  • Epithelioid variant rarely has t(12;16)(q13;p11) - TLS-CHOP, more commonly seen in myxoid and round cell liposarcoma (Histopathology 2005;46:334)
Differential diagnosis
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