The favoured diagnosis by the radiologist is an ALT currently which is a type of liposarcoma

Got it. Thank you for that clarification—that changes things significantly.

What the radiologist is saying:

An ALT (Atypical Lipomatous Tumor) is indeed a type of liposarcoma. It's the most common form of liposarcoma, accounting for about 40-45% of cases. ALTs are characterized by:

• Predominantly fatty composition (which matches your report's "predominantly fat signal")
• Internal septations (the divisions seen on your scan)
• Heterogeneous areas that enhance with contrast (the non-suppressed areas lighting up after gadolinium)
• Generally slower growth pattern compared to other liposarcoma subtypes

The mild interval growth your report notes (from 3 x 1 x 5 cm to 3.5 x 1.2 x 5 cm) is consistent with ALT behavior—these tumors can grow slowly over time.

What you need from your oncology team:

1. Confirmation of the ALT diagnosis and grade
2. Whether this lesion in your foot is your primary tumor or a recurrence
3. Treatment recommendations based on size, location, and grade
4. Surveillance plan if observation is the current approach

According to NCCN Guidelines for Soft Tissue Sarcoma, management of ALT depends on factors like grade, size, and whether it's been previously treated.

Your oncologist will determine the best path forward for your specific situation.

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.