A case of myxoid liposarcoma of the retroperitoneum: a challenging tumour for diagnosis and treatment

Abstract

Retroperitoneal sarcomas are rare neoplasms that account for only 1%-2% of all solid tumors and liposarcomas represent the most frequent histological type. We describe the case of a 44-year-old female with a retroperitoneal myxoid liposarcoma of 22 × 19 × 8 cm in size. The only symptoms were persistent pain and progressive tenderness of the abdomen lasting for two months. The mass was radically excised during laparotomy. CT and MRI were useful to clarify the site of origin of the tumor, relationships with other organs, and planning surgery but final diagnosis was based on histological findings. Here we review the literature about the challenging diagnosis, treatment, and prognostic factors of this disease.

Figure 1

Abdominal ultrasonography showing a solid, heterogeneous retroperitoneal mass with multiple foci of variable size, occupying most of abdominal and pelvic cavity.

Figure 2

Computed tomography (CT) of the abdomen and the pelvis confirming the presence of a 22 × 19 × 8 cm retroperitoneal mass, extending anteriorly to abdominal wall of right upper quadrant and winding the entire distal right kidney.

Figure 3

Macroscopic appearance of the mass which is well encapsulated and multilobed. It has gelatinous and rubbery consistency.

Figure 4

Microscopically, neoplastic mass consists of round to polyhedral cells, which had round, often eccentric nuclei and abundant eosinophilic granular and microvacuolated cytoplasm, myxoid areas, suggesting a histological diagnosis of a retroperitoneal myxoid liposarcoma.