Liposarcoma: The importance of clinical recognition by general physicians

Introduction: Liposarcoma is a malignant tumor deriving from fat cells and the second most common sarcoma of soft tissues. It occurs most often in middle-aged and older men (over 40 years). Sarcomas are rare tumors. The incidence in Europe is 4-5/100.000 people per year and there is no difference between countries. A patient may notice a painless, deeply rooted mass in the soft tissue. They are mostly found on the extremities, retroperitoneum, and rarely on the neck and head. The majority of patients have no symptoms until the tumor reaches the size which may be pressuring the surrounding tissue, causing pain and organ dysfunction. Prognosis depends on the type of sarcoma. Diagnosis is based on medical history, clinical examination, CT scan, biopsy, and pathohistological analysis. The treatment is surgical with adjuvant radiation therapy. Objective: We presented two case reports and the aim was to point out the importance of general physician (GP) in early diagnosing of liposarcoma, which may lead to a high percentage of healed patients. Case report: A male patient, 62, presents with neck lump he has had for two years. It`s been growing slowly. The patient was operated and the pathohistological findings showed it was atypical, lipomatouse tumor/well-differentiated liposarcoma. A female patient, 77, housewife, suffers from u lump in the coccygeal area, which was operated on very often (considered to be sinus pilonidalis). After the last operation, a pathohistological analysis was performed and it was found to be epithelioid sarcoma/well differentiated. Conclusion: Every GP should ask questions about the medical history, perform a clinical examination, pay attention to alarm symptoms, all the while bearing in mind differential diagnosis of this rare disease. Thus he may contribute to early diagnosing and successful treatment of the disease.