This narrative review covers the full spectrum of lipomatous soft-tissue tumors — from benign lipomas to high-grade liposarcomas — with a focus on MRI criteria that distinguish them, when biopsy is required, and how to avoid the well-documented problem of unplanned sarcoma excision.
When you see a large deep fatty mass, don't assume lipoma — get MRI first, and if it enhances, has thick septae, or lacks uniform fat signal, refer to a sarcoma center before touching it.
The 40.6% pre-biopsy rate is a patient-safety indictment: unplanned excision of a sarcoma forces re-resection, reconstruction, and potentially worse oncologic outcomes.
This narrative review covers the full spectrum of lipomatous soft-tissue tumors — from benign lipomas to high-grade liposarcomas — with a focus on MRI criteria that distinguish them, when biopsy is required, and how to avoid the well-documented problem of unplanned sarcoma excision.
When you see a large deep fatty mass, don't assume lipoma — get MRI first, and if it enhances, has thick septae, or lacks uniform fat signal, refer to a sarcoma center before touching it.
The 40.6% pre-biopsy rate is a patient-safety indictment: unplanned excision of a sarcoma forces re-resection, reconstruction, and potentially worse oncologic outcomes.