Two-stage surgery for intraperitoneal and retroperitoneal multicentric liposarcoma causing hydronephrosis: a case...

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Liposarcoma is a common soft tissue sarcoma originating from fat cells, typically occurring in the retroperitoneal space.
• Multicentric liposarcoma, involving multiple distinct tumor sites, is exceptionally rare.
• This case highlights a large, multicentric liposarcoma impacting abdominal and retroperitoneal spaces, complicated by infection and ureteral obstruction.

Purpose of the Study:

• To describe a rare case of multicentric liposarcoma.
• To detail the surgical management of large, complex liposarcomas.
• To emphasize the effectiveness of a staged surgical approach for such cases.

Main Methods:

• A 46-year-old male presented with abdominal symptoms and was diagnosed with large intra-abdominal and retroperitoneal tumors via CT scan.
• The intra-abdominal tumor caused hydronephrosis and an abscess, necessitating emergent resection.
• A second-stage surgery was performed after renal function recovery to remove the retroperitoneal tumor. Histopathology confirmed myxoid/round cell liposarcoma.

Main Results:

• Successful resection of both large intra-abdominal and retroperitoneal liposarcomas was achieved through a two-stage surgical procedure.
• The patient's renal function was preserved, and complications like hydronephrosis and abscess were resolved.
• Adjuvant chemotherapy was administered, and the patient remained recurrence-free for 9 months post-operation.

Conclusions:

• Multicentric liposarcomas, though rare, require tailored surgical strategies.
• A two-stage surgical approach is a viable and rational option for managing complex, large liposarcomas, especially when renal function is compromised.
• This case demonstrates successful oncological and functional outcomes with a staged resection and adjuvant therapy.