En bloc multivisceral resection for a giant retroperitoneal dedifferentiated liposarcoma: technical considerations

Retroperitoneal sarcomas are rare, aggressive malignancies that often present late owing to the retroperitoneum's anatomical expansibility. Dedifferentiated liposarcoma is the most common high-grade subtype. We describe the technical management of a 65-year-old man with a giant retroperitoneal dedifferentiated liposarcoma involving multiple adjacent organs, treated by radical en bloc multivisceral resection including the kidney, adrenal gland, spleen, and distal pancreas. Postoperative recovery was complicated by a Grade B pancreatic leak and a left pleural effusion, managed with percutaneous and thoracic drainage, respectively. Histology confirmed a dedifferentiated liposarcoma resected with clear (R0) margins. At 18 months, no radiological recurrence had been observed, although this follow-up interval remains short relative to the recurrence interval reported for high-grade dedifferentiated liposarcoma. This case illustrates the technical conduct of multivisceral resection for a giant retroperitoneal sarcoma and the perioperative surveillance required to manage expected complications such as pancreatic leak.