Giant retroperitoneal liposarcoma: A case report and literature review

Abstract

Retroperitoneal liposarcomas are a heterogeneous group of mesenchymal tumours that have a wide spectrum of histological subtypes and vague clinical presentations. Herein, we present the case of a 75-year-old man with anorexia, weight loss of 7 kg, and a growing abdominal circumference within a span of 6 weeks. Computed tomography of the abdomen and pelvis showed a large mass that filled almost the entire abdominal cavity. After consultation with a multidisciplinary tumour board, en bloc resection of the tumour was performed. In addition, the left kidney and a part of the left diaphragm were removed. The tumour measured 35 × 29 × 20.5 cm and weighed 11.6 kg. The histological report confirmed low-grade dedifferentiated liposarcoma with scarce atypical adipocytes, lipoblasts containing spindle cell, pleomorphic, and chondroid components. The patient had uneventful recovery and remained stable during the follow-up period. We report this case to highlight the need for customized surgical oncological measures in the treatment of solid abdominal tumours due to locoregional invasion that usually necessitates en bloc resection.

Keywords: Abdominal mass; Giant retroperitoneal sarcoma; Liposarcoma; Multidisciplinary team; Surgery.

Figure 1

Preoperative CT scan of the giant liposarcoma. Sagittal (A), coronal (B, C), and axial images (D, E); *left kidney.

Figure 2

Perioperative illustrations showing the tumour's gross characteristics at initial surgical exposure (A) and deeper dissection (B).

Figure 3

Macroscopic examination of the tumour with a central necrotic area.

Figure 4

Histological examination of the liposarcoma. Atypical lipomatous areas (A); spindle cell and pleomorphic areas (B); chondroid differentiation (C); pleomorphic cells with Touton giant cells and lipoblasts (D).