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. 2015:9:23-6.
doi: 10.1016/j.ijscr.2015.02.019. Epub 2015 Feb 17.

Giant retroperitoneal liposarcoma: Case report and review of the literature

Antonio Caizzone  1 , Edoardo Saladino  1 , Francesco Fleres  2 , Cosimo Paviglianiti  1 , Francesco Iaropoli  1 , Carmelo Mazzeo  1 , Eugenio Cucinotta  1 , Antonio Macrì  1
Affiliations

Giant retroperitoneal liposarcoma: Case report and review of the literature

Antonio Caizzone et al. Int J Surg Case Rep. 2015.

Abstract

Aim: Retroperitoneal soft-tissue sarcomas are relatively uncommon diseases, the most frequent histotype, ranging from 20% to 45% of all cases, is represented by liposarcoma, which is a hard-to treat condition for its local aggressiveness and clinical aspecificity.

Presentation of case: We report a case of a 64-years-old woman who underwent surgical resection for a giant pleomorphic retroperitoneal liposarcoma.

Discussion: Currently chemotherapy for retroperitoneal soft-tissue sarcomas is no effective, and radiotherapy has limited efficacy due to the toxicity affecting adjacent intra-abdominal structures, showed validity only in case of high-grade malignancy by reducing local recurrence, but with no advantage in overall survival. Nowadays only, the complete surgical resection remains the most important predictor of local recurrence and overall survival.

Conclusion: The removal of a retroperitoneal sarcoma of remarkable size is a challenge for the surgeon owing to the anatomical site, to the absence of an anatomically evident vascular-lymphatic peduncle and to the adhesions contracted with the contiguous organs and with the great vessels. Therefore, we believe that, particularly for large-size diseases associated to high-grade malignancy, a complete surgical resection with removal of the contiguous intra and retroperitoneal organs when infiltrated represents the only therapeutic option to obtain a negative margin and therefore an oncological radicality.

Keywords: Myxoid areas; Radical treatment; Retroperitoneal liposarcoma; Soft tissue sarcomas.

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Figures

Fig. 1
Fig. 1
CT scan showing the presence of the bulky lesion stretching from the subhepatic region to the pelvic cavity, displacing the right kidney to the left.
Fig. 2
Fig. 2
CT scan showing the macroscopic intralesional characteristics, consisting of the presence of areas with different fat density and thick septa associated with an inhomogeneous solid component featuring sovrafluid-density coarse components.
Fig. 3
Fig. 3
Evidence of the close relationship between the lesion and the right kidney and the origin from the right retroperitoneal region at the level of the ipsilateral parietocolica space.
Fig. 4
Fig. 4
Right retroperitoneal cavity as it appeared once the lesion had been removed and the right nephrectomy had been performed, with evidence of the structures that had close relations of contiguity with it. The inferior vena cava is easily recognizable as well as the iliopsoas muscle, gonadal blood vessels and right iliac vessels.
Fig. 5
Fig. 5
Picture of the removed surgical specimen including the right kidney.
See this image and copyright information in PMC

References

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