Comparison of Well-Differentiated Liposarcoma and Lipoma
10.4055/jkoa.2026.61.1.65
- Author:
Si Woon KIM
1
;
Jeung Il KIM
;
In Sook LEE
;
You Seon SONG
;
Kyung Un CHOI
Author Information
1. Departments of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
- Publication Type:Original Article
- From:The Journal of the Korean Orthopaedic Association
2026;61(1):65-71
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to differentiate well-differentiated liposarcoma (WDLPS) from lipoma using the magnetic resonance imaging (MRI) findings and improve the preoperative diagnostic accuracy between the two tumors. Although lipoma is a benign tumor that does not necessarily require surgical intervention, WDLPS exhibits local aggressiveness and typically necessitates surgical excision, making its differentiation clinically significant.
Materials and Methods:Among 363 patients diagnosed with lipoma or WDLPS at the authors’ institution between January 2013 and April 2022, 45 patients with lipoma and 15 with WDLPS were selected using propensity score matching based on age and sex. The following six MRI features were analyzed: tumor size, shape, septal thickness, tumor depth, fat content ratio, and the presence of nodular non-fatty tissue components. The sensitivity and specificity of each feature were evaluated.
Results:Among the MRI features, the fat content ratio (specificity 95%) and the presence of nodular non-fatty tissue components (specificity 98%) were useful for excluding WDLPS, but their sensitivities were relatively low (46% and 27%). The sensitivities of other features, such as tumor size, shape, septal thickness, and depth, ranged from 47% to 67%, suggesting that MRI alone has limitations in reliably distinguishing the two tumors. In addition, fat content ratios below 75% and the presence of nodular non-fatty tissue components were significantly more common in WDLPS than in lipoma.
Conclusion:The MRI findings can serve as a useful tool for excluding WDLPS when differentiating it from lipoma. Nevertheless, MRI alone has limitations in achieving a definitive diagnosis because of the low sensitivity of individual features. Therefore, additional approaches such as radiomics analysis, artificial intelligence algorithms, and multicenter studies, are needed to improve the diagnostic accuracy and establish personalized treatment strategies.
