Abstract:
BACKGROUND:Atypical lipomatous tumours (ALT) are common adipocytic tumours. Due to their large size and deep-seated location, wide resection might result in severe functional deficits. The question which margins should be aimed is hence discussed controversially. METHODS:Forty consecutive patients underwent limb-sparing resections. Margins were defined as R0 (wide resection), R1 (marginal resection) or R2 if tumour was left. All patients were followed for evidence of local recurrence or remote metastases. Overall and recurrence-free survival was calculated. RESULTS:The mean age at the time of surgery was 61.9 years. The mean tumour diameter was 17 cm with no patient having metastatic disease. In 8 cases a wide (R0) resection, in 31 cases a marginal (R1) and in one patient a R2-resection was performed. The median follow-up time was 40 months. Four patients died due to causes that were not tumour-related. 3 (7.5%) patients (all R1) developed local recurrences. Two of our 3 recurrences in this series occurred in 6 already recurring cases. We observed no dedifferentiation of tumours and no metastatic disease. CONCLUSIONS:ALT represents a comparatively common diagnosis in large deep-seated lesions of the extremities, especially in patients over 60 years. Marginal resection shows an acceptable rate of local recurrence. The risk of dedifferentiation as proven also in a metaanalysis of the English literature of the last 30 years is close to 1%, metastatic disease is exceedingly rare.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Rauh J,Klein A,Baur-Melnyk A,Knösel T,Lindner L,Roeder F,Jansson V,Dürr HRdoi
10.1186/s12891-018-2053-3subject
Has Abstractpub_date
2018-05-17 00:00:00pages
152issue
1issn
1471-2474pii
10.1186/s12891-018-2053-3journal_volume
19pub_type
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