{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:09:45Z","timestamp":1777637385484,"version":"3.51.4"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,11,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Deep lipomatous tumours can be benign lipomas or intermediate\/locally recurring atypical lipomatous tumours (ALTs). Differentiating between these two entities clinically and radiologically is difficult. The aims of this study were to report a series of deep lipomatous tumours, comparing the clinical, radiological and pathological features of ALTs and lipomas; and to predict the likelihood of a lipomatous tumour being ALT based on anatomical site and MRI characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective review of patients with deep lipomatous tumours presenting over 6 years to a tertiary sarcoma centre, with preoperative MRI, and preoperative or postoperative histology including MDM2 gene analysis. Sensitivity, specificity, predictive values and accuracy in diagnosing ALT were calculated for MRI and histopathological features.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 248 patients were included; 81 (32\u00b77 per cent) had a final diagnosis of ALT. ALTs were larger than lipomas (median 19 versus 10 cm; P &amp;lt; 0\u00b7001); there was no ALT smaller than 5 cm. A tumour presenting in the lower limb was more likely to be an ALT than a lesion at any other site (48\u00b74 versus 13\u00b75 per cent; P &amp;lt; 0\u00b7001). In patients with lipomatous tumours at sites other than the lower limbs, MRI had a negative predictive value of 95 per cent for excluding ALT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Despite concern, most deep lipomatous tumours (nearly 70 per cent) are benign lipomas. Certain features imply that tumours are almost never ALT: smaller than 5 cm or located outside the lower limb with no suspicious characteristics on MRI. Tumours with these features might safely and confidently be managed outside tertiary sarcoma centres.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.11309","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T12:13:35Z","timestamp":1568117615000},"page":"1794-1799","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic performance of MRI and histology in assessment of deep lipomatous tumours"],"prefix":"10.1093","volume":"106","author":[{"given":"L","family":"Cairncross","sequence":"first","affiliation":[{"name":"Department of Academic Surgery, Sarcoma Unit, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0579-1193","authenticated-orcid":false,"given":"H A","family":"Snow","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery, Sarcoma Unit, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D C","family":"Strauss","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery, Sarcoma Unit, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M J F","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery, Sarcoma Unit, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O","family":"Sjokvist","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery, Sarcoma Unit, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Messiou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Thway","sequence":"additional","affiliation":[{"name":"Department of Pathology, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery, Sarcoma Unit, Royal Marsden Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"2022100812461515300_bjs11309-bib-0001","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1002\/jso.20975","article-title":"Diagnosis and management of lipomatous tumors","volume":"97","author":"Dalal","year":"2008","journal-title":"J Surg Oncol"},{"key":"2022100812461515300_bjs11309-bib-0002","doi-asserted-by":"crossref","first-page":"5618","DOI":"10.4081\/or.2014.5618","article-title":"Intramuscular lipoma: a review of the literature","volume":"6","author":"McTighe","year":"2014","journal-title":"Orthop Rev (Pavia)"},{"key":"2022100812461515300_bjs11309-bib-0003","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/j.jamcollsurg.2013.06.003","article-title":"The General Surgeon's quandary: atypical lipomatous tumor vs lipoma, who needs a surgical oncologist?","volume":"217","author":"Fisher","year":"2013","journal-title":"J Am Coll Surg"},{"key":"2022100812461515300_bjs11309-bib-0004","volume-title":"WHO Classification of Tumours of Soft Tissue and Bone","author":"Fletcher","year":"2013","edition":"4th"},{"key":"2022100812461515300_bjs11309-bib-0005","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.humpath.2016.08.009","article-title":"Differential diagnosis of atypical lipomatous tumor\/well-differentiated liposarcoma and dedifferentiated liposarcoma: utility of p16 in combination with MDM2 and CDK4 immunohistochemistry","volume":"59","author":"Kammerer-Jacquet","year":"2017","journal-title":"Hum Pathol"},{"key":"2022100812461515300_bjs11309-bib-0006","first-page":"258","article-title":"Well-differentiated liposarcoma (atypical lipomatous tumors)","volume":"18","author":"Laurino","year":"2001","journal-title":"Semin Diagn Pathol"},{"key":"2022100812461515300_bjs11309-bib-0007","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3109\/17453678109050105","article-title":"A consecutive 7-year series of 1331 benign soft tissue tumours. 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