# Clinico-Radiological-Pathological Correlation in a Rapidly Evolving Well-Differentiated Orbital Liposarcoma: A Case Report

## TL;DR

A rare case of a fast-growing orbital liposarcoma shows that rapid changes in imaging do not always mean the tumor is more aggressive, highlighting the need for detailed pathology in diagnosis.

## Contribution

This case report demonstrates that rapid progression in orbital liposarcomas does not equate to dedifferentiation, emphasizing the importance of histopathological confirmation.

## Key findings

- Rapid clinical and radiological changes in the tumor did not correlate with dedifferentiation.
- Histopathological analysis confirmed a well-differentiated liposarcoma despite aggressive imaging features.
- The case underscores the necessity of integrating clinical, radiological, and pathological data for accurate diagnosis and treatment.

## Abstract

Rapidly progressing orbital liposarcomas, while rare, pose significant diagnostic challenges due to their varied clinical and radiological presentations. A 76-year-old female presented with a suspected well-differentiated orbital liposarcoma 16 months after the onset of proptosis and diplopia. Initial magnetic resonance imaging (MRI) revealed a homogeneous, high-intensity mass in the left superior orbit. Although oral corticosteroids were administered, the patient’s condition worsened over the following 13 months, with subsequent MRI revealing a heterogeneous mass. Orbital exenteration was performed, and histopathological analysis confirmed the diagnosis of a well-differentiated liposarcoma despite the rapid progression and imaging changes.

This case highlights that rapid clinical and radiological changes in orbital liposarcomas do not necessarily indicate dedifferentiation. The discrepancy between imaging progression and histopathological findings emphasizes the critical role of pathological evaluation in making a definitive diagnosis. Treatment decisions, including aggressive surgical approaches, should be based on a comprehensive assessment of the clinical presentation, imaging features, and histopathological characteristics tailored to the individual patient's condition and disease progression.