Left-sided compartmental resection of an 18 kg retroperitoneal liposarcoma: a case report

Retroperitoneal liposarcomas are uncommon malignancies that often remain clinically silent and may attain massive size at diagnosis. Complete surgical excision with negative margins is the cornerstone of treatment; however, this is technically challenging due to indistinct anatomical planes and proximity to major vascular and visceral structures. Compartmental resection has been advocated to improve oncological outcomes, particularly with regard to local recurrence. We report a 43-year-old hypertensive male who presented with progressive abdominal distension and left-sided abdominal pain. Imaging demonstrated a large fat-containing retroperitoneal mass extending across the midline with multivisceral involvement. The patient underwent left-sided compartmental resection, including left nephrectomy, distal pancreaticosplenectomy, and left hemicolectomy. The resected specimen weighed 18 kg. Histopathology reported a dedifferentiated liposarcoma with negative margins. This case demonstrates the safety and feasibility of compartmental resection in achieving R0 resection in massive retroperitoneal liposarcoma.