A 60 years old female with giant retroperitoneal liposarcoma
Danilo Coco1,&, Silvana Leanza2
1Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy, 2Department of General Surgery, Carlo Urbani Hospital, Jesi, Ancona, Italy
Danilo Coco, Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy
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Retroperitoneal tumors give non-specific symptoms until they have reached a substantial size. Liposarcoma and leiomyosarcoma are the most common retroperitoneal carcinoma amount of 70% and 15% respectively. Hodgkin´s and non-Hodgkin lymphoma and epithelial tumors or metastatic disease are less common. We present a 60-year-old female who was referred to the Emergency Department with acute onset of abdominal distension, nausea, vomiting, right back pain and lipothymia. She had a medical history of essential hypertension and diabetes mellitus. On Physical examination, she had a good performance status, arterial blood pressure was 90/60 mmHg, pulse rate was 120 b/min, oxygen saturation of 93%. Blood exams demonstrated no Lymphocytes 4x 103/mmc, Hemoglobin 7g/dl. Physical examination of the abdomen revealed a giant non-tender mass in the left and midline quadrants. The patient was transfused with 4 units of blood. Abdomen computed tomography (CT) scan revealed a retroperitneal mass of 35 cm involving the stomach, the spleen, the kidney and surrounding the vena cava (A). He was referred to a Multidisciplinary Team (MDT) to perform a CT Scan Fine-Needle-Aspiration (FNA) which confirm a well differentiated liposarcoma. A laparotomy was performed with total excision of retroperitoneal mass (B). At 6th day, the patient was in good clinical condition and he was discharged. Hystopathological finding: well differentiated liposarcoma. French Federation of Cancer Centers Sarcoma Group: Grade 1 tumor differentiation: 1; mitotic count: 1; tumor necrosis: 0 (C).
Figure 1: abdomen CT scan revealed a retroperitneal mass of 30 cm involving the stomach, the spleen, the kidney and surrounding the vena cava (A); total excision of retroperitoneal mass (B); well differentiated liposarcoma, French Federation of Cancer Centers Sarcoma Group: Grade 1 Tumor differentiation: 1; Mitotic count: 1; Tumor necrosis: 0 (C)