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Background and Objectives . Atypical lipomas are uncommon, slow-growing benign tumors. While surgery has been the primary treatment modality, we have managed some patients with radiation (RT) as a component of the treatment and have reported their outcomes in this study.  Methods . A retrospective review of all cases of extremity and trunk atypical lipomas in The Sarcoma Database at the study institution was conducted.  Results . Thirteen patients were identified. All patients underwent surgical resection at initial presentation and received pre- or postoperative radiation for subtotal resection ( n  = 2), local recurrence ( n  = 8), or progressive disease ( n  = 3). The median total radiation dose was 50 Gy. Median followup was 65.1 months. All patients treated with RT remained free of disease at the last followup. No grade 3 or higher late toxicity from radiation was observed. No cases of tumor dedifferentiation occurred.  Conclusion . For recurrent or residual atypical lipomas, a combination of reexcision and RT can provide long-term local control with acceptable morbidity. For recurrent tumors, pre-op RT of 50 Gy appears to be an effective and well-tolerated management approach.

The Use of Radiation Therapy in the Management of Selected Patients with Atypical Lipomas