Massive retroperitoneal dedifferentiated liposarcoma in a young patient

Abstract

Liposarcomas are rare malignant tumors that mostly develop in the retroperitoneum. They have a broad behavioral spectrum, from small masses of tissue to highly aggressive tumors. The dedifferentiation process occurs in up to 10% and it's most likely to occur in the retroperitoneum, a process that not only changes its components but also its prognosis. These tumors can grow to a massive size since most of them do not give any symptoms until they invade the adjacent structures. Timely detection and surgery could avoid all these potentially lethal scenarios. We present a case of a 34-year-old patient, who reported a growing mass in her abdomen that reached massive proportions but remained untreated due to lack of sufficient access to healthcare facilities in her geographic location. After complete removal of the mass the patient underwent complete recovery, dedifferentiated liposarcoma was the final diagnosis.

Figure 1:

(A) Abdominal CT revealed a huge encapsulated retroperitoneal tumor with a soft tissue density, and an area containing a calcification. (B) Massive retroperitoneal dedifferentiated liposarcoma. (C) Mature adipocytes with some enlarged atypical nuclei.

Figure 2:

(A) Abdominal CT: Retroperitoneal tumor that displaced the liver, right kidney and most of the bowel. (B) Giant retroperitoneal mass, the mass had multiple adhesion to adjacent organs making dissection troublesome. (C) Transition towards a fusiform cell sarcoma and areas of benign ossification.

Figure 3:

(A) Giant reddish soft consistency retroperitoneal mass. (B) Abdomen, after successful surgery, the mass was resected and the drains were left in place. (C) Patient on follow-up controls.