Head and neck liposarcomas: A 32 years experience
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.
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