Liposarcoma: State of the Art—A Scoping Review

Figures

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  Figure 2. (A) Computed tomography image shows a well-differentiated liposarcoma located in the upper abdomen, with well-defined borders, fat-like content, and some septa over 2 mm pushing the surrounding tissues. Adapted from Yang, T. et al. (2025) [26] and licensed under CC BY 4.0. (B) Well-differentiated liposarcoma located at the vastus lateralis level in axial and T1 sequences with hyperintensity of the lesion and hypointensity of the septa. Adapted from Natella, R. et al. (2023) [22] and licensed under CC BY 4.0. (C) Well-differentiated liposarcoma on T2-weighted fat-suppressed image reveals a well-defined, low-signal adipose tissue mass with thickened septa in the right thigh. Adapted from Zhang T. et al. (2024) [25] and licensed under CC BY NC 4.0. (D) A dedifferentiated liposarcoma located in the right lower abdomen, with margins imprecisely delimited from the surrounding tissues, and solid content invading the right psoas major muscle. Adapted from Yang, T. et al. (2025) [26] and licensed under CC BY 4.0. (E) Dedifferentiated liposarcoma on T1-weighted images presents as an indistinct adipose tissue mass in the left popliteal fossa with low signal non-fatty areas and heterogeneous…

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  Figure 3. (A) Computed tomography shows a myxoid liposarcoma in the medial part of the subcutaneous soft tissues of the right thigh, measuring 7.3 × 5.6 cm. Adapted from Correa, N. et al. (2026) [33], licensed under CC BY 4.0. (B) Myxoid liposarcoma in axial T1 sequence reveals hypointensity of the lesion. Adapted from Natella, R. et al. (2023) [22] and licensed under CC BY 4.0. (C) Myxoid liposarcoma in axial T2 sequence, with fat suppression, shows hyperintensity of the lesion. Adapted from Natella, R. et al. (2023) [22] and licensed under CC BY 4.0. (D) Contrast-enhanced computed tomography of a pleomorphic liposarcoma located in the lower abdomen with a heterogeneous appearance and clear boundaries. Adapted from Wang, L. et al. (2018) [37] and licensed under CC BY 4.0. (E) Pleomorphic liposarcoma in axial T1-weighted image reveals heterogeneous areas and areas of hyposignals. Adapted from Jo, S.J. et al. (2020) [40] and licensed under CC BY 4.0. (F) Pleomorphic liposarcoma in axial T2-weighted image shows heterogeneous areas and areas of hypersignal. Adapted from Jo, S.J. et al. (2020) [40] and licensed under CC BY 4.0. (G) Contrast-enhanced computed tomography revealed a myxoid…

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  Figure 4. (A) Well-differentiated liposarcoma, lipoma-like subtype that presents rare, atypical cells among adipocytes of various sizes (hematoxylin–eosin staining, ×100, original image from the Clinical Anatomy-Pathology Service, Constanta). (B) Well-differentiated liposarcoma, sclerosing subtype, reveals dense collagenous fibrous tissue among adipocytes of varying sizes, minimal nuclear atypia (hematoxylin–eosin staining, ×200, original image from the Clinical Anatomy-Pathology Service, Constanta). (C) Well-differentiated liposarcoma of inflammatory subtype presents atypical stromal cells in an abundant chronic inflammatory infiltrate (hematoxylin–eosin stain, ×100). Adapted from Choi, J.H. et al. (2020) [53], licensed under CC BY 4.0. (D) Clusters of adipocyte cells arranged in a stromal proliferation composed of spindle cells, as well as a low-grade osteosarcoma component (hematoxylin–eosin stain, ×40). Adapted from Macagno, N. et al. (2017) [59], licensed under CC BY 4.0. (E) Positive nuclear reactivity to MDM2 in well-differentiated liposarcoma (×100, original image from the Clinical Anatomy-Pathology Service, Constanta). (F) Positive reactivity to S100 in well-differentiated…

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  Figure 5. (A) Dedifferentiated liposarcoma shows an abrupt transition between the well-differentiated component and the high-grade non-lipogenic component (hematoxylin–eosin staining, ×100). Adapted from Choi, J.H. et al. (2020) [53], licensed under CC BY 4.0. (B) Dedifferentiated liposarcoma with transition zone between well-differentiated and non-lipogenic components of neoplastic spindle cells (hematoxylin–eosin staining, ×100). Adapted from Anderson W.J. et al. (2021) [69], licensed under CC BY 4.0. (C) The MDM2 reaction is present in the dedifferentiated area (×100). Nishio, J. et al. (2021) [61], licensed under CC BY 4.0. (D) CDK4 is present in the nucleus in dedifferentiated liposarcoma (×100). Adapted from Anderson W.J. et al. (2021) [69], licensed under CC BY 4.0. (E) Positive reaction to p16 in dedifferentiated liposarcoma (×200, original image from the Clinical Anatomy-Pathology Service, Constanta). (F) Positive reaction to alpha-smooth muscle actin in the dedifferentiated muscular component of dedifferentiated liposarcoma (×200, original image from the Clinical Anatomy-Pathology Service, Constanta).

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  Figure 6. (A) Myxoid liposarcoma composed of moderate cellularity and spindle and stellate cells arranged in an abundant myxoid stroma with plexiform vessels (hematoxylin–eosin staining, ×100). Adapted from Correa, N. et al. (2026) [33], licensed under CC BY 4.0. (B) Myxoid liposarcoma composed of round-to-ovoid tumor cells, univacuolated lipoblasts, and prominent thin-walled blood vessels. Adapted from Anderson W.J. et al. (2021) [69], licensed under CC BY 4.0. (C) High-grade myxoid liposarcoma composed of hypercellularity of primitive round cells. (hematoxylin–eosin staining, ×200, original image from the Clinical Anatomy-Pathology Service, Constanta). (D) Myxoid liposarcoma with diffuse nuclear positivity for DDIT3 (×100). Adapted from Anderson W.J. et al. (2021) [69], licensed under CC BY 4.0. (E) Nuclear p53-positive myxoid liposarcoma (×100, original image from the Clinical Anatomy-Pathology Service, Constanta). (F) Pleomorphic liposarcoma composed of large, atypical, multivacuolized lipoblasts with indented hyperchromatic nuclei, dispersed on a background of atypical spindle cells (hematoxylin–eosin staining, ×100). Adapted from Lee, A.T.J. et al. (2017) [38], licensed under CC BY…

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  Figure 1. PRISMA diagram showing the process of identifying, screening, and including studies for this analysis of liposarcomas. From the three databases studied, 171 articles entered the screening process, of which 113 met the study eligibility criteria.

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  Figure 7. Schematic of therapeutic options for dedifferentiated liposarcoma.

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  Figure 8. Schematic of therapeutic options for myxoid liposarcoma.