Robot-assisted nephrectomy for retroperitoneal liposarcoma compressing the kidney: a case report with urological...

Area of Science:

• Oncology
• Surgical Oncology
• Urologic Oncology

Background:

• Retroperitoneal liposarcoma (RPLS) is a common soft tissue sarcoma, often asymptomatic until compressing adjacent organs.
• Surgical resection is the primary treatment for RPLS, but combined urological management for kidney involvement is uncommon.
• Giant RPLS, especially when involving the kidney, presents unique surgical challenges.

Purpose of the Study:

• To evaluate the feasibility and safety of a robot-assisted retroperitoneal approach for a giant retroperitoneal liposarcoma (RPLS) involving the kidney.
• To establish a standardized urological management strategy for similar complex RPLS cases.
• To expand the application scope of robot-assisted retroperitoneal surgery for large RPLS.

Main Methods:

• A 54-year-old female with a 250 mm giant RPLS compressing the right kidney underwent robot-assisted retroperitoneal tumor resection, right nephrectomy, and retroperitoneal lymph node dissection.
• The procedure was performed using the Da Vinci Xi Surgical System via a retroperitoneal approach, following NCCN Guidelines.
• Postoperative pathology and immunohistochemistry confirmed the diagnosis; patient recovery and follow-up imaging were monitored.

Main Results:

• Successful completion of robot-assisted retroperitoneal surgery for a giant RPLS (250 mm) with right nephrectomy.
• Uneventful patient recovery with discharge on postoperative day 6.
• No tumor recurrence observed on CT scans at 3 months, 6 months, and 1 year postoperatively; normal renal function maintained.

Conclusions:

• Robot-assisted retroperitoneal approach is feasible and safe for strictly selected giant RPLS (>20 cm) confined to the retroperitoneal space.
• This case expands the application of the retroperitoneal approach beyond moderately sized tumors (<10 cm).
• Provides a standardized urological management reference for RPLS compressing the kidney.