Fisher et al reported an algorithm for managing a patient with a fatty neoplasm that may be an atypical lipoma. The authors are from Winship Cancer Institute and Emory University.
Patient selection: fatty neoplasm and no previous history of sarcoma
Parameters for deciding if lesion significant from current study:
(1) age in years
(2) diameter of tumor in cm
(3) early operation at the same site (previous mass at same site) = recurrent lesion
(4) location (extremity vs torso)
|
Parameter |
Finding |
Hazard Ratio |
|
age in years |
< 55 years |
1 |
|
|
>= 55 years |
2.6 |
|
diameter of tumor |
< 10 cm |
1 |
|
|
>= 10 cm |
16.8 |
|
recurrent tumor |
no |
1 |
|
|
yes |
5.6 |
|
location |
torso |
1 |
|
|
extremity |
6.4 |
Additional reasons to suspect that the lesion is significant:
(1) imaging findings are suspicious for neoplasm (nodularity, sepatations, variation in fat composition)
(2) there are other reasons to suspect neoplasm
Management factors:
(1) likelihood of significant pathology
(2) comfort with performing an oncologic resection
|
Significant Lesion |
Comfort with Oncologic Surgery |
Management |
|
no |
NA |
local resection |
|
yes |
no |
refer |
|
yes |
yes |
radical resection |
Specialty: Hematology Oncology, Surgery, general, Surgery, orthopedic
ICD-10: ,
