Elsevier

Auris Nasus Larynx

Volume 37, Issue 3, June 2010, Pages 347-351
Auris Nasus Larynx

Head and neck liposarcomas: A 32 years experience

https://doi.org/10.1016/j.anl.2009.08.003Get rights and content

Abstract

Objective

The aim of this review is to study natural history, presentation, treatment and prognosis of head and neck liposarcomas.

Methods

We carry a retrospective study about 15 patients diagnosed and treated in our department between 1969 and 2001. Therapeutic modalities included surgery, radiotherapy and chemotherapy.

Results

Tumors were mostly localized at the neck (4 cases) and the scalp (3 cases). Cervical lymphadenopathy was found in 1 case. Chest X-ray found showed metastases in 2 cases. Histological types of liposarcomas were the following: myxoid (5 cases), well differentiated (4 cases), pleomorphic (4 cases), round cell (1 case) and dedifferentiated (1 case). Twelve patients underwent surgery. Complete excision was performed in 7 cases. In the other 5 cases, exeresis was incomplete and 4 of them received postoperative radiotherapy.

Three patients were not operated because of vascular involvement (1 case) or metastasis (2 cases), and they all received radiotherapy alone. After initial treatment, complete remission was achieved in 7 cases (46.7%). A recurrence occurred in 8 cases (53.3%). Two of these patients were reoperated and another one received chemotherapy. In the other 5 cases, the tumor was uncontrollable and no additional treatment has been proposed. Five-year survival rate was 87% for patients who underwent surgery alone, 75% for those who underwent surgery and postoperative radiotherapy, and 0% for those treated by radiotherapy alone.

Conclusion

The mainstay of treatment of head and neck liposarcomas is surgical excision and the prognosis is largely determined by the histological grade and the clinical stage.

Introduction

Sarcomas are rare neoplasms, which account for only 1% of all head and neck primary cancers [1]. Head and neck sarcomas represent 5–15% of all sarcomas in adults, and 35% of all sarcomas in paediatric population [2]. Liposarcoma is one of the most common soft tissue sarcomas occurring in adults. However, all major reviews have demonstrated that it rarely develops in the head and neck region.

The aim of this review is to study natural history, presentation, treatment and prognosis of this neoplasm with comparing our results with those of the literature.

Section snippets

Materials and methods

We carry a retrospective study about 15 patients having liposarcomas diagnosed and treated in our department between 1969 and 2001. All patients had complete clinical examination and radiological investigations (ultrasound, CT-scan, chest X-ray). Fine-needle aspiration cytology (FNAC) and surgical biopsy were performed in 2 and 8 cases, respectively. Diagnostic was based on anatomic pathology. All specimens were re-examined and liposarcomas were reclassified according to Enzinger and Weis

Results

Mean age was 43 years (6 months–80 years) with a peak at the 6th decade (4 cases). Sex ratio was 1.5. Mean period between beginning of symptoms and consultation was 1 year (10 days–6 years).

One patient presenting with a tumor of the scalp has been operated twice 5 and 3 years ago for liposarcoma of the left leg. Another patient had von Recklinghausen's disease. Antecedent of dental extraction was found in a patient who consults for a gingival tumor appearing 10 days later.

All patients presented

Discussion

Liposarcomas represent the most common histological type of sarcomas in adults, and most of them arise in the extremities and the retroperitoneum.

Although head and neck liposarcoma is rare, it is important for specialists to be aware of its natural history, prognosis and treatment. As with liposarcomas elsewhere in the body, most cases present in adults and there is a male predominance. Factors considered to be important in the etiology of liposarcomas include genetics, trauma and irradiation

Conclusion

Liposarcomas rarely develop in the head and neck region. The mainstay of treatment is surgical excision and the prognosis is largely determined by the histological grade and the clinical stage. Complete excision is usually sufficient to cure low-grade tumors (well differentiated and myxoid). However, high-grade tumors (pleomorphic and round cell) are more aggressive and have worse outcome despite the association of surgery and postoperative radiotherapy.

References (21)

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