Pleomorphic Liposarcoma – Causes, Symptoms, Diagnosis, Treatment

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 10 min read
Patient Tools

Read, save, and share this guide

Use these quick tools to make this medical article easier to read, print, save, or share with a family member.

Patient Mode

Understand this article easily

Switch between simple English and easy Bangla patient notes. This is for education and does not replace a doctor consultation.

Pleomorphic liposarcoma (PLS )is a rare and aggressive, fast-growing tumor and high-grade malignancy with high recurrence, poor prognosis, and its treatment is still highly controversial. A rare, fast-growing type of cancer that begins in fat cells. It usually forms in the deep soft tissues of...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Pleomorphic liposarcoma (PLS )is a rare and aggressive, fast-growing tumor and high-grade malignancy with high recurrence, poor prognosis, and its treatment is still highly controversial. A rare, fast-growing type of cancer that begins in fat cells. It usually forms in the deep soft tissues of the arms or legs, but it may also form in the abdomen or chest. Pleomorphic liposarcoma often recurs (comes back)...

Key Takeaways

  • This article explains Symptoms of Pleomorphic Liposarcoma in simple medical language.
  • This article explains Diagnosis of Pleomorphic Liposarcoma in simple medical language.
  • This article explains Treatment of Pleomorphic Liposarcoma in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Before reading

RX Patient Tools

Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.

Start here Choose the right pathway for symptoms, reports, medicines, or urgent warning signs. Disease article roadmap Read this topic step by step: meaning, symptoms, warning signs, diagnosis, treatment, prevention, and follow-up. Treatment planner Prepare questions about treatment choices, benefits, risks, side effects, and follow-up. Family & caregiver guide Organize symptoms, reports, medicines, questions, and follow-up safely. Nutrition & diet guide Prepare food, hydration, supplement, and medicine-timing questions safely. Prevention guide Organize risk factors, protective habits, screening, and warning signs. Recovery guide Prepare a safe plan for activity, rehabilitation, warning signs, and follow-up.
Definition

Pleomorphic liposarcoma (PLS )is a rare and aggressive, fast-growing tumor and high-grade malignancy with high recurrence, poor prognosis, and its treatment is still highly controversial. A rare, fast-growing type of cancer that begins in fat cells. It usually forms in the deep soft tissues of the arms or legs, but it may also form in the abdomen or chest. Pleomorphic liposarcoma often recurs (comes back) after treatment and spreads to other parts of the body, including the lungs.

Pleomorphic liposarcoma is characterized as the growth of a progressively painless mass, and it is easily ignored until the mass is big enough or there are some other compressive manifestations.  It is known that this neoplasm is usually aggressive, occurring in adulthood, and usually in the limbs. Pleomorphic liposarcoma can occur in the mediastinum, liver, orbit, paratesticular region, and also as a purely dermal tumor [,,–]PLS could occur in various organs, but the most common sites are proximal extremities, especially in the lower extremities, and in other uncommon sites including the retroperitoneum, the abdominal wall, the chest wall, the mesentery, the pelvic cavity, the spermatic cord, the mediastinum, the parietal pleura, the pericardium, the foot, the spine, the head, and neck region.[,–]

Grading

According to the guidelines of the ADASP, pleomorphic liposarcoma is considered high grade

French Federation of Cancer Centers System grading scheme for adult sarcomas

  • Tumor differentiation score = 3 for pleomorphic liposarcoma
  • Mitotic index
    • Score 1 0-9 mitoses per 10 hpf (0.1744 sq mm)
    • Score 2 10-19 mitoses per 10 hpf
    • Score 3 >19 mitoses per 10 hpf
  • Tumor cell necrosis
    • Score 0 No necrosis on any slide (one slide per 2 cm tumor diameter)
    • Score 1 <50% of tumor is necrotic on slides examined
    • Score 2 >50% of tumor is necrotic on slides examined
  • Final Grade (add the three scores above)
    • Grade 1 Sum of scores = 2 or 3
    • Grade 2 Sum of scores = 4 or 5
    • Grade 3 Sum of scores = 6 or more

Symptoms of Pleomorphic Liposarcoma

As previously mentioned, most patients are diagnosed with pleomorphic liposarcoma do not have any early symptoms and it can go unnoticed during the initial and primary stages of the disease until the tumor has grown to a large enough size to compress neighboring tissues and cause pain or decreased function.

  • It can sometimes be noticed as a deep-seated mass to touch.
  • Anorexia and abdominal distension, whereas the other patient had persistent pain in the left lower abdomen due to the compression from the pelvic tumor. However, these symptoms were ignored until the mass was big enough or there were some other serious manifestations.
  • Pleomorphic liposarcoma, as with all other cancers, can present with non-specific symptoms such as fevers, chills, fatigue, night sweats, anorexia, and weight loss.
  • If the tumor is retroperitoneal in location, it can present with specific symptoms in the abdomen, including abdominal pain, constipation, gastritis, or flank pain, swelling, and constipation, or the sensation of feeling full sooner than expected after eating.
  • The well-differentiated type tumor is less aggressive and tends to be a large painless mass found in deeper tissues and in the retroperitoneum.
  • Pleomorphic liposarcoma, round cell, and pleomorphic types tend to be in the arms and legs, whereas dedifferentiated tend to be in the retroperitoneum and often associated with the well-differentiated variety.
  • Specifically, pleomorphic liposarcoma is the least common subtype with a high rate of recurrence and poor outcomes.
  • Patients usually present with progressive dysphagia with weight loss
The symptoms of myxoid liposarcoma depend on where the tumor is on your body, but they include:

  • A new or growing lump beneath your skin, especially around or behind your knees or on your thighs
  • Pain or swelling
  • Weakness in an arm or leg that has the lump
  • Feeling full soon after you start eating
  • A new lump anywhere on your body, or an existing lump that grows persistently
  • Painful swelling or numbness in the area around your lump
  • Blood in your stool, or black or tarry stool (an indication of blood)
  • Blood in your vomit
  • Abdominal pain or cramping
  • Constipation
  • Poop that has blood or looks black or tarry
  • Cramping
  • Bloody vomit
  • Your belly gets larger

Tumors in the retroperitoneal, abdominal, and pelvic cavities were larger than those near the body surface such as the subcutaneous and intermuscular tissues.

Diagnosis of Pleomorphic Liposarcoma

Accessory examinations such as CT, ultrasound, and magnetic resonance imaging are critical for surgical methods by assessing the size of the tumor and the degree of tumor infiltration into the surrounding tissues. However, it is difficult to distinguish PLS/Pleomorphic liposarcoma from other liposarcoma and sarcoma using these accessory examinations. The definite diagnosis of PLS still depends on the pathological examination, which reveals highly meta topic cells with granular and/or foamy small vacuoles in cytoplasm, mono-/poly-nuclear giant cells with a deep

Microscopic (histologic) description
  • Well circumscribed but non-encapsulated with infiltrative borders
  • At least focal typical liposarcomatous areas
  • Pleomorphic cells cover > 65% of cut surface with MFH-like, round cell liposarcoma-like (without vascular network), spindle cell liposarcoma-like or epithelioid cells (Mod Pathol 1999;12:722)
  • Usually high grade with an enlarged round to bizarre nuclei
  • Tumor necrosis common
  • Median 25 mitotic figures / 10 HPF
  • May have neutrophils within giant cells, hemangiopericytoma foci, extra- and intracellular hyaline droplets
  • Epithelioid variant often confused with carcinoma

Imaging

  • CT scan, magnetic resonance imaging (MRI) – If you have symptoms of MRCLS, your doctor will use imaging scans such as CT and MRI to look at where the tumor is and how big it is. They will also check for signs that the tumor has spread to other parts of the body. Although none of these techniques is specific, CT scan and MRI can be more helpful in narrowing down the diagnosis: Differential diagnosis is a list of possible conditions that may explain symptoms. সহজ বাংলা: একই লক্ষণের সম্ভাব্য রোগের তালিকা।" data-rx-term="differential diagnosis" data-rx-definition="Differential diagnosis is a list of possible conditions that may explain symptoms. সহজ বাংলা: একই লক্ষণের সম্ভাব্য রোগের তালিকা।">differential diagnosis as both modalities can detect the percentage of a lipomatous/Pleomorphic liposarcoma component of the tumor. Higher fat content is associated with benign lipoma, while less fat is consistent with atypical lipoma or sarcoma. A definitive diagnosis can only be achieved by tissue examination.  And in the majority of the cases, complete resection of the tumor is needed for a correct diagnosis .
  • Removing a sample of tissue for testing – During a biopsy procedure, your doctor removes a small sample of tissue to test for cancer cells. Your tumor’s location determines how the tissue sample is removed.
  • Using advanced lab tests to determine the kinds of cells involved in cancer – Doctors who specialize in analyzing blood and body tissue (pathologists) will study your biopsy samples using specialized laboratory tests, such as immunohistochemistry, cytogenetic analysis, fluorescence in situ hybridization, and molecular genetic testing. These tests provide information about pleomorphic liposarcoma that helps your doctor determine your prognosis and your treatment options.
  • Biopsy – To check if the tumor is MRCLS, your doctor will do a biopsy, taking a small sample from the tumor with a needle. An expert, called a pathologist, will study cells from the sample under the microscope to see what kind of tumor it is.

Treatment of Pleomorphic Liposarcoma

Treatments for pleomorphic liposarcoma include

  • Surgery – The goal of surgery is to remove all of the cancer cells. Whenever possible, surgeons work to remove the entire pleomorphic liposarcoma. If a pleomorphic liposarcoma grows to involve nearby organs, removal of the entire pleomorphic liposarcoma may not be possible. In those situations, your doctor may recommend other treatments to shrink the liposarcoma to make it easier to remove during an operation.
  • Radiation therapy – Radiation therapy uses powerful energy beams, such as X-rays and protons, to kill cancer cells. Radiation may be used after surgery to kill any cancer cells that remain. Radiation may also be used before surgery to shrink a tumor in order to make it more likely that surgeons can remove the entire tumor.
  • Chemotherapy – Chemotherapy uses drugs to kill cancer cells. Not all types of pleomorphic liposarcoma are sensitive to chemotherapy drugs. Careful analysis of your cancer cells by an expert pathologist can determine whether chemotherapy is likely to help you. Chemotherapy may be used after surgery to kill any cancer cells that remain or before surgery to shrink a tumor. Chemotherapy is sometimes combined with radiation therapy.

Conventional chemotherapy pleomorphic liposarcoma is of low efficiency, so new drugs and target therapy might be good options. For example, eribulin and pazopanib are new treatment options for patients with metastatic STS.[,] Eribulin mesylate was reported to have selective activity in LPS.[] However, the adverse effects of eribulin were severe. In a phase III trial, treatment-emergent adverse events occurred in 224 (99%) of 226 patients who received eribulin. Grade 3/4 adverse events were 152 (67%) who received eribulin.[] The Food and Drug Administration (FDA) approved pazopanib as second-line chemotherapy for the treatment of patients with advanced nonlipogenic STS, but still not yet for LPS.[] In addition, eribulin and pazopanib have not been approved for clinical use in China.

Meanwhile, antiangiogenic targeted drugs such as sunitinib, sorafenib, and pazopanib all appeared to demonstrate acceptable antitumor activity in liposarcomas.[–] Moreover, several articles reported that apatinib had a good effect on angiosarcoma[] and round cell liposarcoma.[]

Newer drugs for

Halaven® (eribulin) and Yondelis® (trabedectin) are approved for people who have not responded to earlier treatment, have widespread liposarcoma, or have cancers that cannot be removed via surgery.

Ongoing and Upcoming Clinical Trials of Targeted Therapy and Immunotherapy for Liposarcoma

Drug Name/Code Targets Pathological subtypes of liposarcoma Recruitment Phase ClinicalTrials. gov ID
APX005M CD40 Well/Dedifferentiated liposarcoma Not yet recruiting II NCT03719430
Ribociclib/LEE011 CDK4/6 All Recruiting Ib NCT03009201
Abemaciclib CDK4/6 Dedifferentiated liposarcoma Recruiting II NCT02846987
Ribociclib/LEE011 CDK4/6 Well/Dedifferentiated liposarcoma Recruiting II NCT03096912
Ribociclib/LEE011+Everolimus CDK4/6+mTOR Dedifferentiated liposarcoma Recruiting II NCT03114527
Regorafenib c-Kit, B-Raf, Raf-1, RET, VEGFR1-3, PDGFR β etc. All Recruiting II NCT02048371
Sitravatinib/MGCD516 c-Kit, PDGFR α-β, c-Met, Axl etc. Well/Dedifferentiated liposarcoma Recruiting II NCT02978859
Selinexor/KPT-330 CRM1 Dedifferentiated liposarcoma Recruiting II/III NCT02606461
Selinexor/KPT-330+Ixazomib CRM1+20S proteasome Dedifferentiated liposarcoma Not yet recruiting I NCT03880123
Itacitinib/INCB39110 Jak1 Myxoid/round cell liposarcoma Not yet recruiting I NCT03670069
MAGE-A4ᶜ¹º³²T cells MAGE-A4 Myxoid/round cell liposarcoma Recruiting I NCT03132922
HDM201+Ribociclib/LEE011 MDM2+CDK4/6 Well/Dedifferentiated liposarcoma Active, not recruiting Ib/II NCT02343172
CD8+ NY-ESO-1-Specific T Cells+LV305±CMB305 NY-ESO-1 Myxoid liposarcoma Recruiting I NCT03450122
NYCE T Cells NY-ESO-1 Myxoid/round cell liposarcoma Recruiting I NCT03399448
CMB305±Atezolizumab NY-ESO-1±PD-L1 Myxoid/round cell liposarcoma Active, not recruiting II NCT02609984
NY-ESO-1ᶜ²⁵⁹T cells NY-ESO-1 Myxoid/round cell liposarcoma Recruiting II NCT02992743
Pembrolizumab PD-1 All Not yet recruiting II NCT03899805
Pembrolizumab PD-1 Myxoid/round cell liposarcoma Recruiting II NCT03063632
Nivolumab+Nab-rapamycin PD-1+mTOR All Recruiting Ib NCT03190174
Nivolumab±Ipilimumab PD-1±CTLA-4 Dedifferentiated liposarcoma of the retroperitoneum Recruiting II NCT03307616
Olaratumab PDGFR α All Active, not recruiting III NCT02451943
Olaratumab PDGFR α Myxoid/round cell, pleomorphic or dedifferentiated liposarcoma Recruiting II NCT02584309
Efatutazone PPAR-γ Myxoid liposarcoma Active, not recruiting II NCT02249949
Pazopanib VEGFR 1-3, c-Kit & PDGF-R All Recruiting II NCT01532687
Pazopanib VEGFR 1-3, c-Kit & PDGF-R Dedifferentiated, or myxoid liposarcoma Recruiting II NCT02357810
Lenvatinib VEGFR 2/3 Dedifferentiated, myxoid, or pleomorphic liposarcoma

 

References

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician
Tests to discuss with doctor
  • Temperature chart and hydration assessment
  • CBC with platelet count if fever persists or dengue/other infection is possible
  • Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Pleomorphic Liposarcoma – Causes, Symptoms, Diagnosis, Treatment

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

More from this topic
  1. Combined Immunodeficiency with Childhood-Onset Kaposi Sarcoma

    DefinitionCombined immunodeficiency with childhood-onset Kaposi sarcoma is a very rare genetic immune system disease. In this disease, a gene called TNFRSF4 does not work properly. This...

    February 14, 2026 • Rx Cancer (A - Z)
  2. Collecting Duct Renal Cell Carcinoma

    DefinitionCollecting duct renal? cell carcinoma is a rare and very aggressive type of kidney cancer. It starts in the small tubes at the very end of...

    February 10, 2026 • Rx Cancer (A - Z)
  3. Collecting Duct Carcinoma of the Kidney

    DefinitionCollecting duct carcinoma of the kidney is a very rare and very aggressive type of kidney cancer. It starts in the last part of the kidney...

    February 10, 2026 • Rx Cancer (A - Z)
  4. Kidney Collecting Duct Carcinoma

    DefinitionKidney collecting duct carcinoma is a rare, very aggressive type of kidney cancer. It starts in the tiny tubes at the end of the kidney’s filtering...

    February 10, 2026 • Rx Cancer (A - Z)
  5. Carcinoma of the Collecting Duct of the Renal Tubule

    DefinitionCarcinoma of the collecting duct of the renal? tubule is a rare and very aggressive cancer that starts in the tiny tubes in the middle part...

    February 10, 2026 • Rx Cancer (A - Z)
  6. Bellini Carcinoma

    DefinitionBellini carcinoma is a very rare and very aggressive type of kidney cancer. It starts in the last part of the tiny tubes in the kidney...

    February 10, 2026 • Rx Cancer (A - Z)
  7. Collecting Duct Carcinoma

    DefinitionCollecting duct carcinoma is a rare and very aggressive type of kidney cancer. It starts in the tiny tubes at the end of the kidney’s filtering...

    February 10, 2026 • Rx Cancer (A - Z)
  8. Paediatric Kidney Clear Cell Sarcoma

    DefinitionPaediatric kidney clear cell sarcoma (often shortened to clear cell sarcoma of the kidney, CCSK) is a rare type of kidney cancer that happens mainly in...

    January 29, 2026 • Rx Cancer (A - Z)
  9. Clear Cell Sarcoma of the Kidney (CCSK)

    DefinitionClear cell sarcoma of the kidney (CCSK) is a rare type of kidney cancer that happens mostly in young children, usually under 5 years of age....

    January 29, 2026 • Rx Cancer (A - Z)
  10. Cystic-Multilocular Variant; Grawitz Tumor

    DefinitionCystic-multilocular variant; Grawitz tumor is a type of kidney cancer that forms many fluid-filled spaces (cysts) separated by thin walls inside the kidney. It belongs to...

    January 28, 2026 • Rx Cancer (A - Z)