LIPOSARCOMAS OF THE HEAD AND NECK

Between 1977 and 1992 four patients with liposarcomas of the head and neck region were treated and regularly reexamined at the ENT departmen t of the University of Tuebingen. Our patients were aged 19, 64, 66, a nd 73 years at primary diagnosis. Three patients were female and one w as male. The tumors were located in cheek/parotid gland, the neck, the tracheoesophageal region and larynx/hypopharynx. In three patients co mplete primary resection was planned. In three cases further surgery w as necessary due to recurrences. Two patients are free of tumor for se ven and nine years, respectively. One patient was irradiated with 70 G y four years after primary surgery since she had developed an unresect able recurrence. She died eleven years later aged 79 without residual liposarcoma (autopsy). One patient aged 76 rejected a radical resectio n and underwent a functional tumor reduction and is alive in fairly go od condition. Histologically we found one myxoid and three well-differ entiated liposarcomas. Metastatic spread was not observed. Wide tumor excision is the therapy of choice. Unresectable tumors can be irradiat ed successfully (up to 70 Gy are necessary). Representative studies on the value of chemotherapy have not yet been presented. The main facto r in clinical behavior and prognosis of this rare tumor is the histolo gical subtype. While well-differentiated and myxoid liposarcomas show almost no metastasis and good prognosis, the pleomorphic and round cel l type do metastize, reccur more often, and have a significantly worse prognosis.