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• W2087645214 abstract "Atypical lipomas are slow-growing tumors that most commonly arise in the trunk and extremities. While surgery has been the primary treatment modality, we have managed some patients with recurrent tumors with radiation as a component of the treatment. In this study, the outcome of thirteen patients with atypical lipoma treated with radiation therapy (RT) at the study institution with at least 2 years of follow-up is reported. A retrospective review of all cases of atypical lipoma in the extremities and trunk identified in the Sarcoma Database in the Department of Radiation Oncology at the study institution was conducted. Treatment records and data from follow-up visits of patients were reviewed. Thirteen patients were identified. All the patients underwent surgical resection at initial presentation. Six patients initially had gross total resection, with local recurrence identified at a mean of 68.4 months (range, 20.0 - 133.8 months). The recurrent tumor was treated with pre-operative RT and excision (n=4), or excision followed by post-operative RT (n=2). Four patients had subtotal resection; two of them received adjuvant RT at time of initial treatment, while the other two ultimately required RT with (n=1) or without excision (n=1) for progressive disease after initial resection at 58.1 and 46.3 months. Three patients had surgery with extent of resection unknown; one received excision, chemotherapy and re-excision (all delivered at an outside institution), followed by local recurrence after 27.4 months; another underwent three excisions within a span of five years, followed by local recurrence 5 years after last resection; and the last patient had two excisions in a span of 12 years, followed by local recurrence 10.3 years after last resection. These three patients received either pre-operative RT (n=2) followed by excision, or excision and brachytherapy (n=1). Median total dose 50 Gy, range, 50-70 Gy. Median follow-up was 65.1 months (range, 3.7-196.0 months). All patients treated with RT remained free of disease at last follow-up. No grade 3 or higher toxicity from radiation was observed. There was one case of grade 2 sciatic neuropathy, which occurred in a patient who received 60 Gy of radiation in the adjuvant setting. No cases of tumor dedifferentiation occurred. Atypical lipomas are slow-growing tumors that can be controlled initially with resection. They have a tendency to recur locally but do not metastasize. For recurrent or residual tumors, a combination of re-excision and RT can provide long-term local control with acceptable morbidity. For recurrent tumors, pre-op RT of 50 Gy appears to be an effective and well tolerated management approach." @default.
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• W2087645214 date "2012-11-01" @default.
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• W2087645214 title "Management of Atypical Lipomas With Radiation" @default.
• W2087645214 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1746" @default.
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