Giant Intra-Abdominal Tumor, Compatible with Liposarcoma: A Case Report and Literature Review

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Vascular Surgery

Background:

• Retroperitoneal liposarcoma (RPLS) can grow to giant sizes, encasing vital structures and posing significant surgical challenges.
• Limited efficacy of chemotherapy and radiotherapy for RPLS necessitates effective surgical strategies.
• Complete surgical resection (R0) is the primary treatment and most crucial prognostic factor for RPLS.

Purpose of the Study:

• To provide surgical insights for managing giant retroperitoneal liposarcoma (RPLS).
• To demonstrate the feasibility of a combined surgical approach for complex RPLS cases.
• To underscore the importance of multidisciplinary collaboration and advanced imaging in RPLS resection.

Main Methods:

• A case report of a 59-year-old male patient with a giant retroperitoneal liposarcoma.
• Preoperative imaging with 3D vascular reconstruction to assess tumor involvement.
• Surgical intervention involving vascular-oriented resection (VOR) combined with total retroperitoneal lipectomy (TRL).

Main Results:

• Complete tumor removal (R0) was achieved, including the left kidney and partial colon.
• Postoperative recovery showed significant improvement, with resolution of lower-limb edema and dyspnea.
• Pathology confirmed dedifferentiated liposarcoma with specific molecular markers (MDM2/CDK4+, Ki-67 10-30%).

Conclusions:

• Vascular-oriented resection (VOR) combined with total retroperitoneal lipectomy (TRL) is a feasible approach for giant retroperitoneal liposarcoma.
• Preoperative 3D vascular reconstruction and multidisciplinary collaboration are crucial for successful surgical management.
• Despite advances, the high 5-year recurrence rate necessitates further research into effective adjuvant therapies for RPLS.