Giant retroperitoneal liposarcoma: A case report

Int J Surg Case Rep. 2022 Aug:97:107465. doi: 10.1016/j.ijscr.2022.107465. Epub 2022 Jul 30.

Abstract

Introduction and importance: Retroperitoneal liposarcomas are rare malignancy. They can grow usually asymptomatic until large enough to compress the surrounding organ. Giant retroperitoneal liposarcoma with diameter over 30 cm and weight over 20 kg is extremely rare. There has been limited report of giant retroperitoneal liposarcoma.

Case presentation: A 34-year old woman complained about intermittent abdominal discomfort and progressive abdominal distension for last 2 years. There was history of weight loss for last 3 months. CT scan with contrast showed giant right abdominal mass that expanded to the pelvis (30.4 × 28 × 34 × 29 cm), oppressed surrounding organs and displaced the intestine to the left side with no visualization of normal right kidney structure. Complete resection of this retroperitoneal tumor was performed without combined resection of the surrounding organ. The biopsy of tumor showed a well differentiated liposarcoma. We diagnosed this patient with giant retroperitoneal liposarcoma. The postoperative course was uneventful and the patient was discharged on the 3th postoperative day. Last follow up, 3 months after surgical resection, patient had no complaints and there was no recurrence of this retroperitoneal liposarcoma.

Clinical discussion: Complete resection is the predominant treatment of retroperitoneal liposarcoma to avoid recurrence. Successful complete resection of retroperitoneal liposarcoma may increase the 5-year survival rate from 16.7 to 58 %. However, complete resection is a challenge, particularly in the well-differentiated subtype, for the reason that the margins are not easily distinguishable.

Conclusion: Giant retroperitoneal liposarcoma is an extremely rare tumor with high rate of recurrence, depends on some factors such as the histological type and grade, the metastasis, and also completeness of tumor resection. In this case we performed complete resection without combined resection of the surrounding organ. Furthermore, we will continue to observe our patient closely for recurrence.

Keywords: Case report; Complete resection; Giant size; Retroperitoneal liposarcoma.