Retroperitoneal liposarcoma of the intestine: a rare cause of acute abdomen
Keywords:Liposarcoma, Retroperitoneal, Surgery, Colectomy
Retroperitoneal liposarcoma is a rare malignant mesenchymal tumor with an incidence of 2.5 per million individuals. It is usually asymptomatic until its large enough to compress the surrounding organs, so its early diagnosis is difficult. In current case a 41 year old male patient with no significant past medical history presented to emergency department with sudden onset of abdominal pain in the left lumbar region. On examination, the abdomen was distended, guarding and rigidity present with tenderness to palpation in the left lumbar region, and no mass was palpated. Abdominal USG revealed a large heterogeneous mass in the left lumbar region. As the origin of the mass was uncertain, the patient was evaluated with CECT of the abdomen which revealed a retroperitoneal mass highly s/o liposarcoma. Given the suspicion of a liposarcoma, the patient underwent an abdominal exploration and there was a retroperitoneal mass of 12x8 cm adherent to the left colon. Wide resection of this mass was done along with left colectomy and the specimen was sent for examination. The histopathology study determined lipomatous tumor well differentiated retroperitoneal liposarcoma. Retroperitoneal liposarcoma is a malignant tumor whose treatment is fundamentally surgical. These tumors tend to be resistant to radiotherapy and/or chemotherapy. Among the most important prognostic factors related to survival is surgery with non-affected margins.
Mendenhall WM, Zlotecki RA, Hochwald SN, Hemming AW, Grobmyer SR, et al. Retroperitoneal soft tissue sarcoma. Cancer. 2005;104:669-75.
Russell WO, Cohen J, Enzinger F. A clinical and pathological staging system for soft tissue sarcomas. Cancer. 1977;40:1562-70.
Stoeckle E, Coindre JM, Bonvalot S. Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French cancer center federation sarcoma group. Cancer. 2001;92(2):359-68.
Bradley JC, Caplan R. Giant retroperitoneal sarcoma: a case report and review of the management of retroperitoneal sarcomas. Am Surg. 2002;68:52-6.
Windham TC, Pisters PW. Retroperitoneal sarcomas. Cancer Control. 2005;12(1):36-43.
Wanchick K, Lucha P. Dedifferentiated retroperitoneal liposarcoma presenting as lower gastrointestinal bleeding, a case report and review of the literature. Military Med. 2009;174(3):328-30.
Leão P, Vilaça S, Oliveira M, Falcão J. Giant recurrent retroperitoneal liposacrcoma initially presenting as inguinal hernia: review of literature. Int J Surg. 2012;3(3):103-6.
Pisters PW, O'Sullivan B. Retroperitoneal sarcoma: combined modality treatment approaches. Curr Opin Oncol. 2002;14(4):400-5.
Singer S, Antonescu CR, Riedel E, Brennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma Ann Surg. 2003;238(3):358-70.