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

• Published in: International journal of surgery case reports Vol. 95; p. 107152
• Main Authors: Evola, Giuseppe, Schillaci, Riccardo, Reina, Martina, Caruso, Giovambattista, D'Angelo, Maria, Reina, Giuseppe Angelo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2022; Elsevier
• Subjects: Case Report; Liposarcoma; Retroperitoneal; Sarcoma; Surgery; Well-differentiated; Well-differentiated; Case report; Retroperitoneal; Sarcoma; Surgery; Liposarcoma
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2022.107152

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.
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.
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.
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.
•Liposarcoma is the most common type of retroperitoneal sarcoma.•Early diagnosis of retroperitoneal liposarcoma is a challenge due to its nonspecific clinical presentation.•Computed tomography and magnetic resonance imaging are the most relevant imaging modality for diagnosis•Surgery represents a potentially curative treatment of retroperitoneal liposarcoma.