The Importance of Radiologic Signs for Giant Lipoma Differentiation From Low-grade Liposarcoma and Its Most Appropriate Surgical Treatment Protocol

Dev lipom, liposarkom, rezeksiyon, lokal nüks, fonksiyonel ABSTRACT Objective: This study aimed to evaluate the importance of preoperative radiologic signs for giant lipoma differentiation from low-grade liposarcoma and reveal the appropriate surgical method. Methods: This study retrospectively evaluated 59 patients who underwent marginal and wide resection for giant lipomas (21 were females and 15 were males) and low-grade liposarcomas (14 were females and 9 were males). Pre-biopsy radiological signs were investigated using magnetic resonance images. The pre and postoperative functional results were evaluated using the Upper Extremity Functional Index (UEFI), Lower Extremity Functional Index (LEFS), and visual analogue scale (VAS). The functional results were evaluated according to the marginal and wide resection of these lesions. Results: The preoperative radiologic signs revealed no significant correlations between the thin septa with the giant lipoma or low-grade liposarcoma. However, a significant correlation was determined between the thick septa and globular area with low-grade liposarcoma and homogeneous mass with giant lipoma. Postoperative mid-term UEFI, LEFS, and VAS of the marginal and wide resection were significantly better than the preoperative functional results in both lesions. No differences were found between the preoperative and postoperative mid-term functional results in the marginal and wide resections of either lesion. Local recurrence was detected in four patients with low-grade liposarcoma who underwent marginal resection. Conclusion: Therefore, thick septa, confluent globular area, and nonadipose mass are distinctive for low-grade liposarcoma, and homogeneous mass is distinctive for giant lipoma. Moreover, it would be more appropriate to treat low-grade liposarcomas with wide surgical resection. (n=9) was performed in mild and moderate thin septa and wide resection (n=14) in globular area, moderate and pronounced thick septa, and mild, thick septa with moderate or pronounced thin septa.