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Introduction: Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) is the most common subtype of liposarcoma, accounting for 30-40% of all cases. It is a locally aggressive tumor that does not metastasize but is still capable of causing significant morbidity and mortality, especially if located in the retroperitoneum. It shows amplification of 12q13-15 region containing several genes, including MDM2 and CDK4.

The terms ALT and WDL are considered synonymous. The choice of one term over other is based on location. Some authors prefer the term "well-differentiated liposarcoma" for deep seated tumors in the retroperitoneum, mediastinum or spermatic cord which cannot be completely resected and are associated with significant morbidity and mortality.

This image of ALT/WDL shows an admixture of lipoma-like and sclerotic areas which contain atypical stromal cells.

Image 9 of 85