Well-differentiated/dedifferentiated liposarcoma
B. Core needle biopsy of the lesion
Core needle biopsy should be performed to obtain tissue diagnosis. Incisional biopsy should be avoided and can complicate surgical and oncologic management.1 Surgical management should be deferred until a tissue diagnosis is made and preoperative workup is complete. Because this tumor is enlarging, larger than 5 cm, deep (subfascial), and heterogeneous, it should be considered malignant until proven otherwise. Repeat imaging is unnecessary and likely would be inadequate.
Liposarcomas are rare, often aggressive, malignancies that require surgical resection and multidisciplinary management. There are approximately 2400 new cases of liposarcoma diagnosed in the United States per year.2,3 Subtypes of liposarcoma include well-differentiated, dedifferentiated, myxoid, and pleomorphic. A well-differentiated liposarcoma of the extremity may also be referred to as an atypical lipomatous tumor.