For a decade, Melissa Fellows lived with an abdominal mass that doctors ruled was benign. Initially, it was only for a small lump, on the left side of the stomach, that this mother of three children consulted. We are now in 2009 and the practitioner wants to be reassuring. “My doctor examined it and told me it was common, purely cosmetic, and that I had nothing to worry about.”she remembers. But little by little, and despite an impressive evolution in size, Melissa always receives the same verdict.
A growing tumor and increasingly severe pain
Over time, the mass becomes larger and more and more painful. In 2017, the pain becomes “excruciating” and growth accelerates. “I’ve always been thin, but this fatness was like carrying a toddler on your hip”she explains.
In 2019, the size of the tumor hinders his daily life: climbing stairs or carrying out simple tasks becomes difficult.“All the doctors told me it was safe, and I believed them. My mental health really suffered.”she confides.
Late diagnosis of a rare cancer
It is only after extensive examinations (CT scan, MRI and biopsy) that the diagnosis is made: liposarcoma, a rare cancer of fatty tissues.
The tumor, removed in 2019, measures 30cm by 30cm and is described by surgeons as “one of the biggest” they have ever seen.
“My world fell apart, but finally I felt raw,” she says. “When I finally received the diagnosis, it was almost a relief, because I was finally believed.”
What is liposarcoma, this often silent cancer?
As Dr Sophie Piperno-Neumann, medical oncologist at the Institut Curie and specialist in rare tumors, explained to True Medical, sarcomas are one of the rare cancers, with less than 6 cases per 100,000 inhabitants per year. Liposarcomas, which develop in fat cells, are the most common sarcomas.
“Schematically, it is a ball of fat which grows more or less quickly”, specifies the specialist. When growth is slow, the tumor can push out neighboring organs without causing symptoms for years. “It happens that we discover tumors weighing 10 or 20 kg in the stomach of a patient”she emphasizes.
These tumors can appear anywhere in the body, especially in the thighs or abdomen, and most often affect people over the age of 50, although they can occur at any age.
Lipoma or liposarcoma: a common confusion
Confusion with a benign lipoma is common. Lipomas are superficial, mobile, painless and generally harmless balls of fat.
“Approximately 2% of the population is affected by lipomas”recalls Dr Piperno-Neumann.
But the specialist insists on an essential rule: “One fatty ball in 200 is a liposarcoma, the other 199 are lipomas”. Hence the crucial issue of not trivializing a persistent mass, especially if it grows.
When faced with a suspicious mass, treatment must be codified. “Any lump, painful or not, which appears on the surface or in depth and measures more than 5 cm is a sarcoma until proven otherwise”insists the oncologist.
The diagnosis is first based on medical imaging: ultrasound for a superficial mass, MRI for a deep mass, in order to assess its size, location and relationships with the organs. A biopsy is then essential to confirm the nature of the tumor, ideally decided during a multidisciplinary consultation meeting bringing together radiologists, surgeons, oncologists and pathologists.
Rapid treatment, decisive for the prognosis
As with any cancer, the standard treatment is surgical. “The best treatment is to remove the tumor completely, with safety margins around it,”
explains Dr. Piperno-Neumann.
This delicate cancer surgery must be planned in expert centers specializing in sarcomas, because early treatment clearly improves the chances of survival. About 30% of liposarcomas can metastasize, but they remain “curable if well taken care of“, insists the specialist.
An illness already in terminal phase and a fight to warn
In Melissa Fellows’ case, unfortunately, the diagnosis came too late. Despite the removal of the tumor, several operations and chemotherapy, the cancer spread and was declared terminal.
“If I had had a scan or a biopsy in 2009, I would not be in this terrible situation”she regrets.
Today, she lives with “a ticking time bomb” and campaigns for any persistent growth to be systematically examined. “My message is simple: never let a doctor ignore a lump that continues to grow.”she warns.
Official recognition also concluded that earlier treatment could have allowed his recovery, illustrating the capital importance of acting quickly when faced with an unusual mass, even when it seems benign.