Liposarcomas of the hypopharynx: a systematic review of the literature

Introduction: Liposarcomas are considered the most common type of soft tissue sarcoma in adults. They represent approximately 20% of all mesenchymal malignancies and most frequently involve the retroperitoneum, trunk and extremities. Hypopharyngeal localisation of a liposarcoma is extremely rare. To determine the prevalence of liposarcomas of the hypopharynx, we conducted a systematic review of the literature. Methods: We performed a systematic search of the literature until 2015 using PubMed and Ovid. The search identified 28 cases of hypopharyngeal liposarcomas. The inclusion criteria were: clinical trials, cohort studies, case-control studies, case reports and case series on hypopharyngeal liposarcomas. From an initial 77 articles, 23 articles were selected for this systematic review. The natural history, imaging features, histology, treatment and prognosis were analysed. Results: The incidence peaked in the sixth and seventh decades. Diagnostic procedures were based on the barium swallow test, endoscopic examinations, and computed tomography (CT)/magnetic resonance (MR) imaging. A well-differentiated liposarcoma represented the most frequent histological subtype. Surgical excision was the main treatment. Endoscopic resection appeared to be useful for peduncolated tumours of the hypopharynx. The 1-year disease-free survival rate was 89.47%. Conclusions: A hypopharyngeal liposarcoma is a rare pathology, but it should kept in mind when a mass of the hypopharynx is discovered. A cervical approach is better, irrespective of the size of the tumour, except for cases in which an endoscopic approach is feasible. Local recurrence is common. Therefore, patients should undergo regular examinations, at least for up to 5 years.