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. 2022 Jun:95:107152.
doi: 10.1016/j.ijscr.2022.107152. Epub 2022 May 3.

Giant retroperitoneal well-differentiated liposarcoma presenting in emergency with intestinal occlusion: Case report and review of the literature

Giuseppe Evola  1 , Riccardo Schillaci  2 , Martina Reina  2 , Giovambattista Caruso  2 , Maria D'Angelo  2 , Giuseppe Angelo Reina  2
Affiliations

Giant retroperitoneal well-differentiated liposarcoma presenting in emergency with intestinal occlusion: Case report and review of the literature

Giuseppe Evola et al. Int J Surg Case Rep. 2022 Jun.

Abstract

Introduction and importance: Liposarcoma (LPS) represents the most common type of retroperitoneal sarcoma (RPS) and can be classified into four subtypes. Preoperative diagnosis of retroperitoneal liposarcoma (RLPS) is a challenge because of its late and nonspecific clinical presentation. Imaging may be helpful for determining the correct diagnosis. Surgery represents a potentially curative treatment of RLPS.

Case presentation: A 55-year-old Caucasian female presented to the Emergency Department with a two-day history of abdominal pain, abdominal distension, inability to pass gas or stool, nausea, vomiting and lipothymia. Abdominal examination revealed abdominal distention, abdominal pain without obvious muscle guarding and a giant non-tender mass. Laboratory tests reported neutrophilic leukocytosis and anemia. Abdominal contrast-enhanced computed tomography (CECT) showed a heterogeneous and hypodense giant retroperitoneal mass compressing and displacing the surrounding organs and vessels. The patient underwent excision of a giant retroperitoneal mass. The postoperative course of the patient was uneventful.

Clinical discussion: RLPS is a malignant neoplasm that can slowly grow to enormous size with possible involvement of adjacent organs and vessels; it may recur locally and has a minimal capacity to metastasize. Preoperative diagnosis and staging of RLPS are important to establish appropriate management and prognosis. Surgery represents the gold standard for non-metastatic RLPS treatment.

Conclusion: RLPS is a rare malignant neoplasm generally difficult to detect early due to its late and nonspecific clinical presentation. CECT represents the most commonly used modality for diagnosis, staging and preoperative evaluation. Surgery represents the appropriate treatment of non-metastatic RLPS.

Keywords: Case report; Liposarcoma; Retroperitoneal; Sarcoma; Surgery; Well-differentiated.

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Conflict of interest statement

All the authors certify that there is no conflict of interest regarding the material discussed in the manuscript.

Figures

Fig. 1
Fig. 1
A, B, C. Abdominal contrast-enhanced computed tomography (CECT) showing a heterogeneous and hypodense (fat density) giant retroperitoneal mass, measuring 36 × 32 × 28 cm, compressing and displacing the surrounding intra- and retro-peritoneal organs and vessels (A axial view, B coronal view, C sagittal view).
Fig. 2
Fig. 2
Giant retroperitoneal fatty mass compressing and displacing the intestine in the right side of the abdominal cavity: operative findings.
Fig. 3
Fig. 3
Total excision of the giant retroperitoneal fatty mass without the need to remove other organs: operative findings.
Fig. 4
Fig. 4
Photomicrograph section of retroperitoneal well-differentiated liposarcoma (haematoxylin and eosin, original magnification ×40).
See this image and copyright information in PMC

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