Clinicopathological characteristics and experience in the treatment of giant retroperitoneal liposarcoma: A case report and review of the literature

Figures & data

Figure 1. A: Appearance of the retroperitoneal liposarcoma as a giant mass. B: At surgery, well-encapsulated tumor and its exact supplying vessels were found. C: Gross appearance of resected tumor, measuring 65 × 45 × 30 cm and weighting 31 kg. D: The cut section of the specimen, showing a homogenous, yellow look.

Figure 2. A and B: Abdominal computed tomography (CT) shows a heterogeneous retroperitoneal mass occupying the entire abdominal cavity, with stomach being pushed aside (red arrow). C and D: The 3-month follow-up CT scan, with the normal stomach (red arrow).

Figure 3. Histopathologic findings. A (original magnification, × 40; hematoxylin and eosin staining) and B (original magnification, × 100; hematoxylin and eosin staining) views demonstrate a well-differentiated liposarcoma.

Table 1. Clinical features, preoperative evaluation, type of therapeutic approach, histopathologic characteristics at diagnosis, follow-up and clinical outcomes of 14 patients with giant RPLS.

No.	Author/year	Sex/age (yr)	Main clinical presentation	Pre- imaging	Pre- histology	Type of intervention	Compli- cations	Weight (kg)	Size(cm)^a	Histological subtype	FNCLCC grade	Complete resection (R)	Adjuvant therapy	Follow- up(mo)	Evolution
1	Hazen B[6] 2016	M/64	Abdominal distention	CT	No	Wide excision	No	41	60×42×31	Poorly- differentiated	Grade III	Yes(R0)	No	NA	NA
2	Oh SD[7] 2016	F/71	Abdominal distention	US CT	No	Wide excision	No	25	45×30×11	Well- differentiated	Grade I	Yes(R0)	No	28	Local recurrence at 16 mo from diagnosis→resection
3	Sharma M[8] 2013	F/60	Increasing in weight and abdominal girth	CT	Yes (FNAC)	Wide excision	No	23	47×40×25	Well- differentiated	Grade I	Yes(R0)	No	6	No recurrence
4	Bansal VK[9] 2012	M/52	Abdominal distention, early satiety and dyspnoea	CT	No	Wide excision with 50 cm of ileum and right middle ureter along with autotransplantation of right kidney	No	24	40×35×35	Mixed	NA	Yes(R0)	No	63	Local recurrence at 40 mo from diagnosis→ resection and adjuvant chemo-radiotherapy
5	Amir M[10] 2011	F/72	Increasing in abdominal girth and prolonged ileus	CT	No	Subtotal piecemeal excision	No	46	NA	Poorly- differentiated	Grade II	No(R2)	No	6	Dead
6	Akhoondinasab MR[11] 2011	M/54	Enlargement of abdomen	US CT	No	Wide excision	Atelectasis	32	58×45×36	Well- differentiated	Grade I	Yes(R0)	No	36	Local recurrence at 12 mo from diagnosis→resection
7	De Nardi P[12] 2011	M/40	Increasing in abdominal girth	CT	No	Wide excision	No	42	50×49×35	Well- differentiated	Grade I	Yes(R0)	No	12	No recurrence
8	Hashimoto Y[13] 2010	M/41	Abdominal swelling, edema and respiratory failure	CT	Yes (FNCB)	Wide excision with right kidney	No	22	45×40×30	Poorly- differentiated	Grade II	Yes(R0)	No	12	No recurrence
9	Clar H[14] 2009	M/66	Increasing in abdominal girth, dyspepsia, asthenia and dyspnoea	CT	Yes (FNCB)	Wide excision with left kidney	Chylo- abdomen	25	47×42×25	Well- differentiated	Grade I	Yes(R0)	No	36	No recurrence
10	Benseler V[15] 2009	M/39	Abdominal distention, dyspnoea, nausea and vomiting	CT	No	Wide excision with left kidney and descending colon	No	45	60×50×36	Well- differentiated	Grade I	Yes(R0)	No	48	Local recurrence at 9 mo from diagnosis→resection
11	Morandeira A[16] 2008	F/63	Abdominal distention, edema and cachexia	CT	No	Wide excision with right kidney, appendix,cholecyst and hystera	No	31	45×43×24	Myxoid	Grade II	Yes(R0)	Chemo- therapy (doxo- rubicin)	24	No recurrence
12	McCallum OJ[17] 2006	F/47	Increasing in abdominal girth and anemia	CT	No	Local excision with hystera,bilateral tuboovarianabscess and paraaortic lymph node	ileus	47	50×48×45	Poorly- differentiated	Grade II	No(R1)	No	35	No recurrence
13	Yol S[18] 1998	M/63	Abdominal mass, constipation,dyspnea and severe edema	US CT	Yes (FNAC)	Wide excision with descending colon	No	42	50×45×32	Myxoid	Grade II	Yes(R0)	Radio- therapy	NA	NA
14	our case, 2016	M/45	Increasing in abdominal girth	CT	No	Wide excision	No	31	65×45×30	Well- differentiated	Grade I	Yes(R0)	No	8	No recurrence

Pre-: preoperative; US: ultrasonography; CT: computed tomography; FNAB: fine-needle aspiration biopsy; FNAC: fine-needle aspiration cytology; FNCLCC: French Federation of Cancer Centers grading system; NA: not available. ^aLongitudinal, transverse, and anteroposterior diameters.