Materiały źródłowe

• #1 Lipoma Pathology – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482343/

  The prognosis for benign lipomas is very good. These are benign entities and carry no risk for malignant transformation. Once these tumors are excised, mainly for cosmetic reasons, they often do not return. However, it is imperative that the fibrous capsule surrounding the lipoma is entirely removed to prevent such from happening.

• #2 Lipoma – American Brain Tumor Association | Learn More

  https://www.abta.org/tumor_types/lipoma/

  Prognosis means a prediction of outcome. Benign lipomas have a good prognosis. There is limited data on the prognosis of liposarcoma.

• #3 Lipomas: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/191233-overview

  The outcome and prognosis are excellent for benign lipomas. Recurrence is uncommon but may develop if the excision was incomplete. […] Pang et al compared outcomes in 238 patients who underwent total or near-total (T/NT) resection for dorsal, transitional, or chaotic spinal cord lipomas (with 16-year follow-up), along with complete reconstruction of the neural placode, with results from 116 patients who underwent partial resection for spinal cord lipomas (with 11-year follow-up). […] Although in the T/NT and partial resection groups the rate of immediate symptom stabilization or improvement was similar (more than 95%), the combined cerebrospinal fluid leakage and wound complication rate was only 2.5% for T/NT resections, compared with 6.9% for partial resections. Moreover, the overall progression-free survival probability (Kaplan-Meier analysis) was 82.8% for T/NT resection patients at 16 years postoperative, compared with 34.6% for partial resection patients at 10.5 years post operation. Evidence indicated that the superior results in the T/NT resection patients were associated with the fact that lower cord-sac ratios were achieved in these patients than in the partial-resection group.

• #4 Surgical Management of Complex Spinal Cord Lipomas: How, Why, and When to Operate | SpringerLink

  http://link.springer.com/10.1007/978-3-319-31512-6_114-1

  Partial resection of complex spinal cord lipomas is associated with a high rate of symptomatic recurrence due to retethering (Pang et al. 2010). […] Twenty-five years of follow-up have proven the long-term benefits of this technique (Pang et al. 2009, 2010; Pang 2015). […] I now strongly advocate for total resection of spinal cord lipomas and radical reconstruction of the neural placode over partial resection because aggressive surgery, contrary to traditional teaching, is safe and gives far better long-term progression-free survival (Pang et al. 2010). […] Long term outcome of total and near total resection of spinal cord lipomas and radical reconstruction of neural placode part II: outcome analysis and preoperative profiling.

• #5 D-dimer Levels in the Differential Diagnosis Between Lipoma and Well-differentiated Liposarcoma | Anticancer Research

  https://ar.iiarjournals.org/content/34/9/5181

  Plasma D-dimer levels are associated with the status of tumor progression, and we hypothesized that D-dimer levels could contribute to differential diagnosis. […] The D-dimer level may be a helpful marker for preoperative differential diagnosis between lipoma and WDLS. […] D-dimer levels indicated poorer prognoses for patients with malignant musculoskeletal tumors. […] Liposarcoma, one of the most frequent soft tissue sarcomas, has several subtypes: well-differentiated liposarcoma (WDLS), dedifferentiated liposarcoma, myxoid/round cell liposarcoma, and pleomorphic liposarcoma. Of these subtypes, WDLS is considered to have the best prognosis. […] In this study, we have demonstrated the usefulness of D-dimer levels for the differential diagnosis between lipoma and WDLS. […] The elevated incidence of WDLS among elderly patients presents an additional bias in our analysis because D-dimer levels are generally elevated in elderly people. […] In conclusion, we found that plasma D-dimer levels are more up-regulated in WDLS than in lipoma. Although not a stand-alone modality for differential diagnosis, the plasma D-dimer level may contribute substantially to the differential diagnosis between lipoma and WDLS.

• #6 The Predictive Role of the Histopathological Scoring System in Adipose Tumors—Lipoma, Atypical Lipomatous Tumor, and Liposarcoma

  https://www.mdpi.com/2075-4418/13/24/3606

  Lipomatous tumors are the most frequent soft tissue neoplasms. […] The score designed in this study shows an increased sensitivity and specificity for the diagnosis of lipomas (100%, respectively, 97%), atypical lipomatous tumors (93.8%, respectively, 82.3%), and liposarcomas (100%, respectively, 90.5%). […] This present study enhances the present data by bringing to attention the histopathological score with a role in differential diagnosis, as well as in the prediction of immunohistochemical and genetic tests. […] The presence of karyomegaly and fibrous proliferation was associated with an increased maximum diameter (p = 0.014, respectively, p < 0.001). [...] A strong association could be highlighted between the presence of cellular atypia and microvascular density. [...] The presence of intratumoral fibrosis was associated with the presence of lipoblasts and necrosis (p < 0.001, respectively, p = 0.017).

• #7 Prediction of lipomatous soft tissue malignancy on MRI: comparison between machine learning applied to radiomics and deep learning | European Radiology Experimental | Full Text

  https://eurradiolexp.springeropen.com/articles/10.1186/s41747-022-00295-9

  Machine learning (ML) applied to magnetic resonance imaging (MRI) radiomics could help to characterise malignancy of lipomatous soft tissue tumours. […] ML/radiomics analysis outperformed DL for the benign/malignant differentiation of lipomatous soft tissue tumours on MRI in a data-limited context. […] In this study, we have shown that ML from MRI radiomics could be relevant to classify patient with lipoma or ALTs and therefore to potentially reduce the number of biopsies. […] Using radiomic features, and traditional ML classifiers, we obtained a sensitivity of 100% and a specificity of 32% on an external validation cohort. It indicates that 32% of biopsies could be avoided for negative patient. […] To conclude, radiomic ML analysis outperformed DL-based approach to predict malignancy in lipomatous soft tissue tumours due to the possibility to a posteriori correct for acquisition heterogeneity.

• #8 The diagnostic accuracy of depth prediction for lipomas by preoperative imaging with distribution according to anatomical site in Korea: a retrospective analysis

  http://www.e-acfs.org/journal/view.php?number=1002

  Lipomas are common benign connective-tissue tumors that usually present as slow-growing, painless, subcutaneous masses. […] Accurate preoperative depth determination is crucial for planning appropriate surgical resection. […] MRI is preferable for the preoperative depth assessment of lipomas, especially those located in the trunk. Accurate imaging is essential for guiding surgical planning and avoiding complications. […] The overall preoperative diagnostic accuracy for assessing the depth of lipomas was the highest with MRI (79.3%), followed by USG (72.5%), and CT, at a relatively lower accuracy of 56.5%. […] Therefore, for masses suspected to be lipomas of the trunk, MRI is recommended over CT to acquire more precise depth information.

• #9 Value of clinical, ultrasonographic and MRI signs as diagnostic differentiators of non-benign lipomatous tumours | Scientific Reports

  https://www.nature.com/articles/s41598-020-77244-2

  Suspicion of malignant change within a lipoma is a common and increasing workload within the UK Sarcoma multidisciplinary team (MDT) network, and a source of considerable patient anxiety. Currently, there is no lipoma-specific data, with regard to which clinical or radiographic features predict non-benign histology, or calculate an odds-ratio specific to a lipomatous lesion being non-benign. […] When each sign is considered independently, (ROC analysis, followed by binary logistic regression) only Ultrasound depth is a significant predictor (p=0.044) of a histologically non-benign lipoma. […] Ultrasound signs (Pseudo R-Square=0.105) are more predictive of the post-operation histology outcome than Clinical signs (Pseudo R-Square=0.082) or MRI tests (Pseudo R-Square=0.052) […] This work challenges the traditional perception of red-flag signs when applied to lipomatous tumours.

• #10 Value of clinical, ultrasonographic and MRI signs as diagnostic differentiators of non-benign lipomatous tumours | Scientific Reports

  https://www.nature.com/articles/s41598-020-77244-2

  Of the clinical tests, depth of tumour is the best predictor of the post-operation histology outcome (non-benign, benign), followed by size of tumour and previous lipoma. […] Of the ultrasound tests, ultrasound depth is the best predictor of the post-operation histology outcome (non-benign, benign), followed by ultrasound tumour vascularity and ultrasound septae. Depth is also statistically significant on ROC analysis. […] Of the MRI tests, heterogeneous features on MRI is the best predictor of the post-operation histology outcome (non-benign, benign), followed by MRI depth. […] Ultrasound and Clinical tests combined (Pseudo R-Square=0.147) are more predictive of the post-operation histology outcome than MRI tests (Pseudo R-Square=0.052).

• #11 The Predictive Role of the Histopathological Scoring System in Adipose Tumors—Lipoma, Atypical Lipomatous Tumor, and Liposarcoma

  https://www.mdpi.com/2075-4418/13/24/3606

  In malignant cases, there is a statistically significant correspondence between MDM2 and CDK4 immunomarkers. […] A cut-off of ≥38.75 vessels/mm2 is predictive for liposarcoma with 94.1% sensitivity and 100% specificity (AUC = 0.999, p < 0.001). [...] This study managed to create a histopathological score with increased accuracy, useful both in the differential diagnosis as well as for the prediction of the immunohistochemical and genetic examinations.

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