Lipoma, generally considered as a benign neoplasia, may occur as liposarcoma lipoma-like or atipycal lipoma, especially when of huge dimension. Pathological features of lipoma and liposarcoma lipoma-like are similar: the pattern is characterized by fatty lobules, with fibrosus septa. The presence of vartiable amount of atipical cell with hyperchromatic, solitary or multiple nuclei is suggestive of liposarcoma lipoma-like or atypical lipoma. The clinical features of these lesions are high rate of local recurrence and a low risk to metastasize. Preoperative work up, ultrasounds and MR have a poor diagnostic value, and no imaging features are so specific to differentiate between lipoma and liposarcoma lipoma-like, except site and size. The surgical treatment of the liposarcoma lipoma-like and atypical lipoma and the postoperative therapy, when required, should be performed in specialized centers. Only the combined approach, surgery and radiotherapy, can result in prevention of local recurrence and malignant transformation. The Authors report two cases of liposarcoma lipoma-like admitted to their Institution and review the Literature.