Clinical, Diagnostic, and Treatment Characteristics of Orbital Liposarcoma

Purpose To clarify the clinical, diagnostic and treatment characteristics of orbital liposarcoma. Design Retrospective observational case series. Methods Review of electronic medical records, histopathology, radiological images and follow-up information of 21 patients with orbital liposarcoma. Results The predominant clinical manifestation of this disease was painless exophthalmos. The most frequently encountered pathological types were well-differentiated and myxoid liposarcoma. Preoperative radiological images from 15 patients showed that orbital liposarcoma initially developed in extraocular muscle in 9 patients. Furthermore, all well-differentiated liposarcomas exhibited the radiographic characteristics of irregular and ill-defined adipose tissue, whereas only 12.5% of myxoid liposarcomas had the imaging characteristics. For the patients who exclusively underwent surgery, all cases with subtotal excisions experienced recurrence, 63.6% of marginal excisions recurred and 50% of wide excisions resulted in recurrence. However, none of the patients who underwent marginal excisions or wide excisions combined with adjuvant radiotherapy exhibited recurrence. The analysis of MRI findings in three patients who underwent neoadjuvant radiotherapy revealed that the tumor size remained stable in a patient with well-differentiated liposarcoma, while another patient with the same type of tumor exhibited a gradual increase in size. Conversely, a patient with myxoid liposarcoma experienced a significant reduction in tumor size following neoadjuvant radiotherapy. Conclusion Orbital liposarcoma demonstrated a propensity for developing in the extraocular muscle. The radiological images of well-differentiated liposarcomas were characterized by irregular and ill-defined adipose tissue. Surgery combined with radiotherapy demonstrates potential in reducing recurrence rates. Notably, orbital myxoid liposarcoma exhibited greater sensitivity to radiotherapy compared to well-differentiated liposarcoma.