Retroperitoneal Soft Tissue Sarcoma and Kidney Autotransplantation: A Case Report

Soft tissue sarcomas (STSs) are rare malignancies, with retroperitoneal soft tissue sarcoma (RPS) constituting 10%-15% of all STSs. RPS often presents late due to minimal early symptoms, typically requiring complete en-bloc resection for optimal survival outcomes. Achieving radical resection can be challenging due to the tumor's proximity to vital organs. In cases where the kidney is involved, a nephrectomy can lead to significant morbidity, especially in patients with pre-existing renal impairment. Kidney autotransplantation offers a unique solution by preserving renal function in these cases, avoiding the need for dialysis and immunosuppressive therapy. This case report presents a 61-year-old female with a large RPS encasing her only functioning kidney. After unsuccessful neoadjuvant chemotherapy, she underwent an en-bloc resection and subsequent autotransplantation. Postoperatively, she experienced complications such as pneumonia and bowel obstruction due to poor clinical status, but after recovery, she has remained disease-free at 1-year follow-up. This case illustrates the potential of kidney autotransplantation in selected cases to prevent treatment-induced renal failure. Although the risk of recurrence is relevant, autotransplantation provides an option for preserving renal function while allowing for curative resection, with careful consideration of the balance between recurrence risk and morbidity.