Liposarcoma in the Axilla Developed from a Longstanding Lipoma

1. Mathes DW, Thornton JF, Rohrich RJ. Management of posterior trunk defects. Plast Reconstr Surg 2006;118:73e-83e. 2. Hallock GG. Reconstruction of posterior trunk defects. Semin Plast Surg 2011;25:78-85. 3. Hamdi M, Van Landuyt K, de Frene B, et al. The versatility of the inter-costal artery perforator (ICAP) flaps. J Plast Reconstr Aesthet Surg 2006;59:644-52. 4. Oh TS, Hallock G, Hong JP. Freestyle propeller flaps to reconstruct defects of the posterior trunk: a simple approach to a difficult problem. Ann Plast Surg 2012;68:79-82. 5. Prasad V, Almutairi K, Kimble FW, et al. Dorsolateral musculocutaneous perforators of posterior intercostal artery: an anatomical study. J Plast Reconstr Aesthet Surg 2012;65:1518-24. Liposarcoma is one of the most common soft-tissue sarcomas in adults, accounting for approximately 20% of all soft-tissue malignancies [1]. It usually occurs in the retroperitoneum and lower extremities and originates from primitive mesenchymal cells deep in the soft tissue, such as intermuscular fascia. The concept of pathogenesis of liposarcoma arising from benign lipoma is generally not accepted, and only few cases suggesting the transformation of benign lipoma into liposarcoma have been reported [2]. We report a rare case of liposarcoma in the axilla that was developed from a longstanding lipoma and review recent concepts concerning the pathogenesis of liposarcoma. A 70-year-old male presented with a recurred huge mass in the left axilla (Fig. 1A). The patient had no mass-related pain but complained of discomfort because of the mass. On physical exam, the mass was non-tender and movable. A preoperative magnetic resonance imaging (MRI) showed a 12 × 10 × 6-cm heterogeneously enhancing mass with a fat signal, suggesting lipoma or well-differentiated liposarcoma (Fig. 1B). He had a history of partial resection of the mass at the same site 11 years before his visit. At that time, because the primary aim of surgery was to improve the external appearance and the mass was adjacent to neurovascular structure, only partial resection was performed and the pathologic diagnosis was lipoma (Fig. 2). Liposarcoma in the Axilla Developed from a Longstanding Lipoma