What’s New in Liposarcoma?

By David Levine,

Thursday, June 18, 2015

Close-up of medical oncologist Mark Dickson attending a presentation.

In this Q&A, medical oncologist Mark Dickson discusses how people with liposarcoma are cared for at Memorial Sloan Kettering, what’s new in diagnosis and treatment, and the research he and his colleagues are conducting to improve patients’ treatment options.

  • Liposarcoma is a rare cancer of the fat tissue.
  • MSK doctors have a lot of experience diagnosing and treating it.
  • They are conducting several clinical trials of new treatments.
  • Genomic testing is now making personalized treatment possible.

Liposarcomas are tumors that arise in the body’s fat tissue. They are relatively rare, affecting only about 2,000 people each year in the United States. But it’s not an unusual disease at Memorial Sloan Kettering: Our doctors and researchers specialize in this and about 50 other types of soft tissue sarcoma.

Mark Dickson is a medical oncologist who specializes in liposarcoma as well as other sarcomas of the soft tissue and bone and Kaposi sarcoma. In a recent interview, Dr. Dickson discussed the challenges of treating liposarcoma and the research he is doing to improve the lives of people living with the disease by finding treatments that are more effective and less toxic.

How are liposarcomas detected and diagnosed?

Symptoms vary depending on the location of the tumor.  For patient with a tumor in the abdomen, a common symptom is weight gain. A patient can gain ten to 20 pounds because some tumors can be very large [between 30 and 50 centimeters in diameter]. Patients who have tumors on their thighs or arms usually notice them right away. But a tumor in the abdomen might not be diagnosed as quickly since people often think their bellies have grown bigger due to normal weight gain. 

Doctors use imaging tests, typically MRIs, to determine how far the disease has spread and to aid in assessing the stage of the tumor. The next step is a biopsy. Since sarcomas are rare, it is important that a surgeon or radiologist who is highly experienced with sarcomas does the biopsy.

Back to top

Why are liposarcomas so difficult to treat?

Sarcomas are rare, and liposarcomas even rarer. The average oncologist might see one sarcoma in a year. That’s why patients are best off coming to a center such as MSK, where sarcomas are routine, not exceptional.

There are four types of liposarcoma. The most common is well-differentiated liposarcoma, low-grade tumors whose cells look like normal fat cells and grow slowly. Myxoid/round cell liposarcomas are intermediate to high-grade tumors, with the round cell being the high-grade form. Pleomorphic liposarcoma is the rarest but sometimes is a very aggressive disease type. And a dedifferentiated liposarcoma is a high-grade tumor that occurs when a lower-grade tumor changes and creates new high-grade cells.

Patients with well-differentiated liposarcoma can survive for decades, but recurrence is a problem. Simple well-differentiated tumors can be removed surgically and the prognosis is often good, but recurrent tumors are more challenging because the cancer can spread to other parts of the body and surgery may not be an option. Radiation has to be used sparingly to avoid side effects, and chemotherapy does not work well for many liposarcomas.

The five-year survival rate for patients with a high-grade liposarcoma is less than 50 percent. That’s why we’re seeking better treatments.

Back to top

What follow-up do patients need after they’re done with active treatment?

Because recurrence can occur from months to decades after the initial diagnosis, people who have been treated for liposarcoma need to be monitored for the rest of their lives. Patients will have follow-up testing — which typically consists of a physical exam and imaging tests to detect metastasis — on a schedule determined by their physician.

Patients are best off coming to a center such as MSK, where sarcomas are routine.
Mark A. Dickson
Mark A. Dickson Medical oncologist
Back to top

Are there any clinical trials for liposarcoma drugs taking place?

There are several clinical trials being conducted at MSK that are centered on well-differentiated and dedifferentiated liposarcomas.

We are testing drugs that will turn off certain genes that become overexpressed in liposarcomas, including the genes CDK4 and MDM2. Ideally we will find a drug as effective as imatinib (Gleevec™), which was developed to target the cancer cells that cause chronic myelogenous leukemia and blocks the production of the abnormal protein that causes cancer. Gleevec is also very effective against some gastrointestinal stromal tumors.

We are seeing particularly promising results with the CDK4-targeting drug PD0332991 (palbociclib). To date, 90 patients have taken part in a phase II trial that looks at the drug’s efficacy. In 2013, we published a preliminary study in the Journal of Clinical Oncology that found that 70 percent of the 30 patients given PD0332991 for 12 weeks did not have their disease progress during that time. This was a higher percentage than expected. In addition, some patients had significant shrinking of their tumors.

Trials for drugs that can inhibit the overexpression of MDM2 are just under way. We are doing phase I trials with the goal of seeing whether a drug is safe to use — and hopefully showing some efficacy. One of the trials involves SAR405838, an investigational anticancer drug. The purpose of this study is to find the highest dose of SAR405838 that can be given safely in patients with liposarcoma and other advanced cancers that have either continued to grow despite standard therapy or for which no standard treatments exist.

Back to top

What other research efforts aimed at liposarcoma are happening at MSK?

Among the challenges of treating sarcomas is that they are not one disease but have different subtypes, so there is a lot of variety between different people’s tumors. For comparison, in melanoma, you’ll find a common type of mutations in the gene BRAF that can be targeted with a drug in approximately 60 percent of patients. We will not find these high percentages in sarcomas. However, even finding a clinically relevant mutation present in a smaller number of patients is helpful. I believe that genomic research will be key in helping patients with liposarcomas.

We are utilizing a test known as MSK-IMPACT™, a targeted tumor-sequencing test that can detect gene mutations and other critical genetic aberrations in both rare and common cancers. The goal is to find aberrations that make cancers vulnerable to particular drugs and to match individual patients with available therapies or clinical trials that will most benefit them. To date, we have done sequencing on about 300 soft tissue sarcomas. 

Back to top


Hi, my father he lives in Chicago and was diagnosed with liposarcoma stage four cancer. The surgeon said that it is a very risky surgery. The tumor is about 9lbs. Is there a way that Sloan can see the results from a CD? The doctors told us that a second opinion will get the same answers he gave us. Can you help us?

Dear Julio, we are sorry to hear about your father's diagnosis. MSK specialists are only able to offer second opinions for people in the United States after an in-person consultation and examination. If your father would like to make an appointment, please ask him to call our Physician Referral Service at 800-525-2225. The staff there an answer any additional questions you may have. Thank you for reaching out to us.

Hi .. My husband diagnosed atumor at right thigh before any treatment surgically removed at november 2015 it was 12 cm .. Diagnosed myxoid liposarcoma then has done ct scan it was metastasized to lung with multiple nodules... At germany started chemotherapy with ifosfamide and doxoorubrucin at 1/1/2016 after 2 courses done ct scan at 10 feb 2016 no shrinkage and no change in volume usless chemotherapy.. The dr said we dont do anything follow up after 2 months... This not agood news plz help is there any treatment.. Biopsy taken from lung it was low grade myxoid liposarcoma they say chemo doesnt work and cant remove by surgery its too much

Mayada, we're sorry to hear about your husband's diagnosis. If are in Germany and you'd like to arrange for a consultation or records review with MSK doctors, please contact our International Center at international@mskcc.org or go to https://www.mskcc.org/experience/become-patient/international-patients for more information. If you are in the US, you can call 800-525-2225. Thank you for your comment.

My son, Willem Gouws age 21, was diagnosed with pleomorphic liposarcoma in the prostate in Nov 2015. They removed his prostate which was 620 grams at the point of removal. He received radiation for 7 weeks which ended end of Feb 2016. He had to start with chemo but about a month ago he had pain over his abdominal area. The scans reflects a mass of 10cm by 5cm in the abdominal muscles. They did a biopsy and was diagnosed as myxoid liposarcoma. The glans in the abdominal area is also enlarged. They would like to remove the abdominal muscles. We are based in Fochville, South Africa and they do not have any alternative way of treatment. I would sincerely appreciate some feedback, I am concerned.
Kindest Regards,
Madelein Gouws

Hi. I actually have a relative undergoing a procedure at your hospital (nothing to do with my question), and we are considering bringing our infant for evaluation..

Here are general questions:

A. Does sarcoma run in family genetics? If an uncle had sarcoma in the abdomen - does this increase the risk of my baby having liposarcoma in anotheer area?

B. How common is liposarcoma in infants (1-2 months old)?

C. If a sonogram shows that it is "lipoma" (=non cancerous) - Could lipoma be 1-3/4 inches in diameter in an infant? Does lipoma usually have red marks adn blood vessels?

I have recently been diagnosed with a 20cm mass in my abdomen which could be a liposarcoma. Any ideas of articles for patients an their families in dealing with this and what to expect?

Taryn, we're sorry to hear you're going through this. If you'd like to learn about MSK's approach to treating soft-tissue sarcomas such as liposarcoma, you can go to https://www.mskcc.org/cancer-care/types/soft-tissue-sarcoma.

If you'd like to make an appointment for a consultation with MSK, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment.

I had a myxiod liposarcoma near my left ankle. It was abou 5cm x 5cm. It was removed and no further treatment was needed. It is grade 2. What are the chances of it recurring?

We recommend you discuss your questions about recurrence with your healthcare team. They should be able to tell you how often you should be going back for follow-up appointments and monitoring. Thank you for your comment.

Hi, I am a 40 year old woman who found a large lump in my thigh that after MRI was diagnosed as a lipoma. It was about 14x6x3cm and was disturbing because I sat on it. one of the sarcomacenters here in Sweden performed surgery and were able to remove the whole tumour. After that they found out that the tumour was an atypical lipoma/atypical lipomatous tumour. They say it's not malignant since it was located in my thigh, but that the risk of reoccurence is slightly bigger than with an ordinary lipoma. I don't need Any more treatment or checkups but if I feel something suspicious in my thigh I'm supposed to contact them, no matter of It is in the near future or twenty years ahead.
My questions are:
1. would you also call the tumour an atypical lipoma or would you call it liposarcoma grade 1?
2. Would you consider My tumour as non-malignant?
3. Do you think that checkups are necessary?
4. How high is the risk of it to come back, how many percent?

Unfortunately, we are not able to answer these very specific questions without a conducting a clinical examination and reviewing your medical history. If you would like to make an appointment with one of our specialists for a second opinion, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

My brother has a tumor on both arms. Doctors suspect it's liposarcoma per mri results. Can it be bi lateral without mestasizies?

Dear Linsdey, we are sorry to hear about your brother. We are not able to answer that without a conducting a clinical examination and additional tests. If he would like to make an appointment with one of our specialists, please ask him to call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

I have a mass from my right him to under my gluteus maximus. It had grow. Very quickly in the last 6 weeks. I started having severe back pain and my chiropractor found it. It not visible but is deep under or in the muscle. Will a sonogram always detext this?

Dear Angela, we are sorry to hear about your mass. If your doctor suspects sarcoma and you make an appointment with a specialist at MSK, we would review your medical history, assess your overall health, and use imaging tests such as such as CT and PET scans or MRI to get a complete picture of the disease. While these tests are very helpful, however, the gold standard for diagnosing sarcoma is a biopsy. In this procedure, we take out a tiny piece of the tumor so that a pathologist can look at it under a microscope.

We recommend that you follow up with your physician or a specialist in this area for further testing to see if soft tissue sarcoma is suspected. If you would like to make an appointment at MSK, please call our Physician Referral Service at 800-525-2225.

To learn more about soft tissue sarcoma and how they are diagnosed, please visit https://www.mskcc.org/cancer-care/types/soft-tissue-sarcoma/about-soft-…. Thank you for reaching out to us.

For recurrence at primary site is biopsy done then removal when under3 cm? Is Radiation a treatment when it was done the first tumor 3 yrs ago Proton Therapy? scheduled to have biopsy 8/1/16 at NYU again. Trying to get apt at MSKMC. I was told to bring in Path report. Surg sched 8/11. Don't want to put it off another week

Dear Cindy, we are sorry to hear about your recurrence. If you would like to make an appointment with a specialist at MSK, please contact our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

My husband has had a lump in his upper abdomen for years, the doctors in Florida don't seem concerned, but 3 weeks ago he noticed several (maybe 15) small lumps in his lower abdomen in the fatty tissue. He has had lipomas or cysts in his trunk area before, but never like this. They appeared quickly and are tender to touch. He thinks he's getting more. What type of Doctor would he go to for an initial diagnosis before we come to SK? He has had lots of nausea over the last few years as well, not sure if that makes a difference? Any info would be appreciated! Thank you

Dear Kathy, we are sorry to hear about your husband. We recommend that you circle back with your husband's physician to report his latest symptoms for additional testing and possible referral to an appropriate specialist. At that point, if he would like to make an appointment with a physician at Memorial Sloan Kettering, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

I was just recently diagnosed with a lipoma and it is very painful on off .people say lipomas are not painful though .my dr.wants to see me back in 3 months .it just does not seen right it slide stabbing searing pain in my right side stomach lower pelvic area.CT was done this couldn't be cancer could it ( sarcoma)

Dear Shannon, we are sorry to hear about your health issues. We recommend that you circle back with your physician to report the severity of your pain and hopefully recommendations on how it can be addressed. You might consider looking into getting a second opinion with a specialist in this area, which may require additional testing. At that point, if you would like to make an appointment with a physician at Memorial Sloan Kettering, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

My mother has pleomorphic sarcoma. She is being seen at Duke presently. Her small town doctor removed a baseball sized tumor that was said to have been done inadequately. She now has about five tumors on her hip and they sit on her sciatic nerve. She is on her 2nd round of chemo...in lots of pain, very ill, sweats, chills, no appetite. Can we get an opinion/consultation by sending records? Our family would like someone with the skill set to remove them before mestatsis occurs further. We were immediately told no at Duke for surgery. Radiation is not being considered. Thoughts on pro-ton therapy?

When a liposarcoma tumor is resected in the posterior thigh and in the event the sciatic nerve is involved, does MKS have the option and ability to do a sciatic nerve graft from a donor cadaver? And would that be done by a plastic and reconstructive surgeon? Thank you.

Hi Ann, we sent your question to sarcoma surgeon Aimee Crago, who replied, "We don't generally reconstruct if we need to remove the sciatic nerve. Most patients who need to have this type of surgery will tolerate the deficit well. It is very rare that we need to do this type of procedure, however. We can almost always save the nerve." Thank you for your comment.


Can one survive or live for a long time with liposarcoma without treatment?

Hi Connie, this is not a question we can really answer, because it depends on where the tumor is located and also whether it spreads to vital organs in the body. If you'd like to make an appointment at MSK, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment.

My Best Friend (Sister) was just diagnosed with Myxoid Liposarcoma in right thigh approx 20cm in length. It is not round cell Myxoid and has not affected the bone. PetScan came back clean everywhere except in right thigh. Her oncologist recommend High dose(in Hospital tx) Chemo 3 Rounds. She completed first round August and is scheduled for second round Sept 12,13,14. After seeing oncologist prior to Sept. Round 2 Chemo. Doctor now states she will need 4-6 Rounds of Chemo prior to Radiation treatment. I am extremely worried about this aggressive Treatment. Would appreciate any feedback.

Hi Kathy, we're very sorry to hear your sister is going through this. Because all cases are different, we are not able to provide comment on individual treatments on our blog. If your sister would like to make an appointment for a consultation at MSK, she can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment.

Can you please explain the differences between well differentiated & dedifferentiated liposarcomas? I see that one is low grade, the other high grade. I am not familiar with the meanings of these diagnostic terms & would like to gain a better understanding of the differences in the types of tumors regarding diagnosis, treatment options & prognosis. Thank you!

Tanya, we sent your question to Dr. Dickson, who replied, "Well-differentiated liposarcoma is considered low grade, which means it tends to be slow-growing and has a low risk of spread or metastasis. It also looks more like normal fat tissue under the microscope and on the CT scan. Dedifferentiated liposarcoma is considered a high-grade sarcoma, which means it can be more aggressive, grow more rapidly, and possibly metastasize." If you or someone you know has been diagnosed and is interested in speaking with one of our experts about treatment, the number to call for an appointment is 800-525-2225. You can go to https://www.mskcc.org/experience/become-patient/appointment for more information. Thank you for your comment.

Are there currently any studies for family members of sarcoma's that run in the family? I had one bio sibling with three separate sarcomas (lipo, leiomyo, and adenocarcinoma - died mid 40's), my nephew had glioblastoma multiform - died 7 years, another brother died of small cell lung cancer that MD's referred to as a sarcoma- died mid 40's, Mom died of adenocarcinoma of lungs - died late 60's, and my bio dad has had two dx of skin cancer (still living in his late 70's to early 80's). I have been tested for the gene T53 and it was negative. I have read that a CHEK gene may also be considered with sarcoma's? If you can suggest where to contact for additional information OR and additional gene testing that would be great. Thank you

Dear Carolyn, we are so sorry to hear about all of the cancer deaths in your family. We recommend that you contact our Clinical Genetics Service and speak with one of our experts there about your family history and which genes may run in your family. You can reach them at 646-888-4050 or go to https://www.mskcc.org/cancer-care/risk-assessment-screening/hereditary-… for more information on genetic counseling. Thank you for your comment.

Hi, My dad had surgery 7 years ago to remove a renal cell (kidney) tumor. Now, it has returned in the same general area as a non-operable liposarcoma, because it encircles the aorta and the vena cava. it's about 12 cm long and 5 cm wide. are there any drugs that can help stop the progress and shrink this tumor? Thank you kindly, Shahriar

Dear Shahriar, we are sorry to hear about your father's diagnosis. We offer clinical trials for people with liposarcoma that may be of interest: https://www.mskcc.org/cancer-care/clinical-trials/search?keys=liposarco….

If you have any questions about these studies or would like to make an appointment for your father, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

I had surgery low grade lipo sarcoma right thigh 9 years ago. It was 18 cm long deep next to my femur. The problem I have is spasms all the time every day. I also had 30 days radiation post operative

Dear Charlene, we are sorry to hear about your health issues. We recommend that you follow up with your physician to discuss and address your specific symptoms and concerns. Thank you for reaching out to us.

I had a 13cm dediffereianred liposarcoma removed in August as well as my right kidney. All CT and PET scans done within a couple weeks of my surgery were negative for spread of the cancer. Surgery went very well at a sarcoma cancer center in Boston with clear margins with no lymph or vascular involvement per the pathology report. Five weeks post surgery went to ER for chest pain and CT revealed fluid around left lung and spots suspicious of the cancer in my lungs! How can that happen so fast?? I currently am on my 3rd round of chemo (doxorubicin and ifasimide) with the hopes of the chemo at least keeping it from spreading. Dr. thinks these small spots may be able to be surgically removed after chemo. Is this a practice Sloan Kettering takes part in?

Thank you,

Dear Sheryl, we are sorry to hear about your diagnosis. If you are interested in making an appointment with one of our specialists about possible next steps in your care (such as surgery) please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

Please, advice on a swelling my 34 year old son has in the left abdominal area under the rib cage area. Just saw a primary care Doctor who told him it appears to be a lipoma. I am a cancer patient fighting breast cancer. Also had a smooth muscle tumor of uncertain malignant potential 16 years ago with a complete hysterectomy. Do you think the odds of him having a lipoma can be determined in a one visit appointment. I'm concerned because I have had quite a few connections to unusual health issues. I don't want him to take anything for granted. Please give me your thoughts! Appreciate!

Dear Brenda, we are sorry to hear about your son's health issues. If you are uncertain about his physician's diagnosis or treatment recommendations, we would suggest that he seek out a second opinion with a specialist. Thank you for reaching out to us.

Back on August 1st I had a CT done that showed a mass that is 24cm x 20cm x 21cm in my abdomen. It has been determined to be a low grade liposarcoma. This was determined by a surgical oncologist from the CT. No biopsies were done. I am a double kidney transplant patient of 20 years. The tumor has completely incased both of the transplanted kidneys. I have no symptoms at all. The game plan is to get another CT December 1st and see how fast the tumor is growing. The transplant team is comfortable when the time comes they will be able to save at least one kidney if not both. Does this plan of watchful waiting make sense. I live close to Pittsburgh, Pa. It would be hard for me to get to your hospital for treatment.

Hi John, because every patient is different, we are not able to comment on diagnostic and treatment strategies on our blog. If you are not able to travel to MSK for treatment, you might want to look at the list of National Cancer Institute-designated cancer centers at https://www.cancer.gov/research/nci-role/cancer-centers to find one that's closer to you. Thank you for your comment, and best wishes.

Add new comment

We welcome your questions and comments. While we share many of them with our world-class doctors and researchers, we regret that in order to protect your privacy, we are not able to make personal medical recommendations on this forum, nor do we publish comments that contain your personal information. If you would like to consult with an MSK doctor, we encourage you to make an appointment at 800-525-2225 or request an appointment online.

Your email address is kept private and will not be shown publicly.