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Case Report: A 55 kg retroperitoneal liposarcoma.

Ren Yingzheng1, An Junjie1, Wang Guifei2

  • 1Department of Gastrointestinal, Pancreatic, Hernia and Abdominal Wall Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.

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|July 3, 2025
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Summary

A massive, well-differentiated retroperitoneal liposarcoma (RPLS) case highlights surgical challenges. Despite complete resection, the patient succumbed to complications, underscoring the need for careful multidisciplinary evaluation in managing large RPLS.

Keywords:
complicationmultidisciplinary teampreventionretroperitoneal liposarcomasurgery

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Pathology

Background:

  • Retroperitoneal liposarcoma (RPLS) is a rare mesenchymal malignancy, often presenting as large, indolent masses due to deep location.
  • Well-differentiated subtypes of RPLS can grow significantly, adhering to vital structures and complicating complete surgical resection.

Observation:

  • A 62-year-old male presented with a 20-year history of abdominal mass, rapidly enlarging in the last five months, causing compression symptoms.
  • Physical examination revealed extreme abdominal distension (165 cm circumference) and visible varicose veins.
  • CT scans showed an immeasurably large, mixed-density retroperitoneal mass with lipid, calcification, and soft tissue components.

Findings:

  • A 55 kg, 70x54x20 cm well-differentiated liposarcoma was surgically resected via multivisceral resection.
  • Postoperative pathology confirmed the diagnosis of well-differentiated liposarcoma.
  • The patient unfortunately died 40 days post-surgery due to multiple organ dysfunction secondary to pneumonia, heart failure, and intra-abdominal infection from anastomotic leakage.

Implications:

  • Complete surgical resection (R0) is the standard for RPLS, but massive tumors necessitate multidisciplinary team (MDT) evaluation of patient fitness, tumor biology, and risks.
  • Staged debulking surgery is an alternative if R0 resection is unfeasible or high-risk.
  • Hyperthermic intraperitoneal chemotherapy (HIPEC) may be considered judiciously on a case-by-case basis for RPLS management.