S1961 Primary Retroperitoneal Mass Due to a Well-Differentiated Giant Liposarcoma

Ovarian dysgerminoma is a rare type of germ cell tumor. The majority of patient relapses occur within 2 years of diagnosis. Here, we report the case of a 74-year-old woman with a history of ovarian dysgerminoma 39 years earlier. The patient visited the hospital presenting with heartburn. An abdominal computed tomography (CT) revealed a right retroperitoneal mass, and a primary retroperitoneal tumor was suspected. She underwent surgical resection of the retroperitoneal tumor. Histological examination confirmed a metastatic dysgerminoma to the retroperitoneum. Postoperative CT showed paraaortic and cervical lymph node metastases. The patient was treated with bleomycin, etoposide, and cisplatin chemotherapy. This case demonstrates the difficulties that may be encountered in the differential diagnosis of a retroperitoneal mass and underlines the necessity for understanding a patient’s clinical history.

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En-block resection of a giant retroperitoneal lipoma presented as huge abdominal swelling: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20213152 ◽

2021 ◽

Vol 8 (8) ◽

pp. 2484

Author(s):

Rajendra Bagree ◽

Rishab Agrawal ◽

Sweta Gupta ◽

Pradeep Panwar ◽

Veena Shukla ◽

...

Keyword(s):

Computed Tomography ◽

Mass Effect ◽

Early Recurrence ◽

Rare Entity ◽

Retroperitoneal Mass ◽

Ct Guided ◽

Abdominal Symptoms ◽

Important Differential Diagnosis ◽

Well Differentiated

Retroperitoneal lipomas are an extremely rare entity with only less than 20 cases described in the literature so far. They can attain immoderate size due to space provided in the retroperitoneum and cause abdominal symptoms like abdominal pain, swelling and obstipation due to mass effect. Case presented here as of 53 years old male with complaint of abdominal swelling that had been progressive for the last 1 year. On computed tomography (CT) it revealed giant retroperitoneal mass? liposarcoma? occupying the space immensely. Intraoperatively, two giant retroperitoneal tumours were found which did not show any features of infiltration to nearby structures, therefore the sole tumour annihilation was achieved, which was diagnosed as benign lipoma on histopathology report later. The most important differential diagnosis is the well differentiated liposarcoma, which could only be confirmed after resection and histopathological assessment. Retroperitoneal lipomas are clearly not distinguishable from well differentiated liposarcomas on CT guided and USG guided biopsy and thus it could be misleading. Hence surgical resection with negative margins along with histopathological confirmation is treatment of choice with regular follow up to diagnose early recurrence if any.

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Primary Retroperitoneal Mass Lesions

Transabdominal Fine-Needle Aspiration Biopsy ◽

10.1142/9789812706713_0008 ◽

2007 ◽

pp. 234-285

Keyword(s):

Retroperitoneal Mass ◽

Mass Lesions ◽

Primary Retroperitoneal

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A Primary Retroperitoneal Mucinous Tumor

Case Reports in Surgery ◽

10.1155/2015/157613 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Alicia A. Heelan Gladden ◽

Max Wohlauer ◽

Martine C. McManus ◽

Csaba Gajdos

Keyword(s):

Case Reports ◽

Mucinous Carcinoma ◽

Malignant Potential ◽

Mucinous Tumor ◽

Retroperitoneal Mass ◽

Surveillance Imaging ◽

Mucinous Neoplasms ◽

Low Malignant Potential ◽

Mucinous Cystadenomas ◽

Primary Retroperitoneal

A twenty-five-year-old female presented with a large retroperitoneal mass. Workup included history and physical exam, imaging, biopsy, colonoscopy, and gynecologic exam. After surgical resection, the mass was determined to be a primary retroperitoneal mucinous tumor (PRMT). Clinically and histologically, these tumors are similar pancreatic and ovarian mucinous neoplasms. PRMTs are rare and few case reports have been published. PRMTs are divided into mucinous cystadenomas, mucinous borderline tumors of low malignant potential, and mucinous carcinoma. These tumors have malignant potential so resection is indicated and in some cases adjuvant chemotherapy and/or surveillance imaging.

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Retroperitoneal liposarcoma of the intestine: a rare cause of acute abdomen

International Surgery Journal ◽

10.18203/2349-2902.isj20211841 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1614

Author(s):

Vikash C. Tiwari ◽

Vaibhav Mudhale ◽

Kulkarni S. Sharang ◽

Jineshwar Nyamagoud ◽

Malluru Srividya

Keyword(s):

Sudden Onset ◽

Wide Resection ◽

Lumbar Region ◽

Retroperitoneal Mass ◽

Significant Past Medical History ◽

Current Case ◽

Retroperitoneal Liposarcoma ◽

Malignant Mesenchymal Tumor ◽

Well Differentiated ◽

Left Lumbar Region

Retroperitoneal liposarcoma is a rare malignant mesenchymal tumor with an incidence of 2.5 per million individuals. It is usually asymptomatic until its large enough to compress the surrounding organs, so its early diagnosis is difficult. In current case a 41 year old male patient with no significant past medical history presented to emergency department with sudden onset of abdominal pain in the left lumbar region. On examination, the abdomen was distended, guarding and rigidity present with tenderness to palpation in the left lumbar region, and no mass was palpated. Abdominal USG revealed a large heterogeneous mass in the left lumbar region. As the origin of the mass was uncertain, the patient was evaluated with CECT of the abdomen which revealed a retroperitoneal mass highly s/o liposarcoma. Given the suspicion of a liposarcoma, the patient underwent an abdominal exploration and there was a retroperitoneal mass of 12x8 cm adherent to the left colon. Wide resection of this mass was done along with left colectomy and the specimen was sent for examination. The histopathology study determined lipomatous tumor well differentiated retroperitoneal liposarcoma. Retroperitoneal liposarcoma is a malignant tumor whose treatment is fundamentally surgical. These tumors tend to be resistant to radiotherapy and/or chemotherapy. Among the most important prognostic factors related to survival is surgery with non-affected margins.

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Fetus In Fetu — A Mystery in Medicine

The Scientific World JOURNAL ◽

10.1100/tsw.2007.56 ◽

2007 ◽

Vol 7 ◽

pp. 252-257 ◽

Cited By ~ 3

Author(s):

A. K. Majhi ◽

K. Saha ◽

M. Karmakar ◽

K. Sinha Karmakar ◽

A. Sen ◽

...

Keyword(s):

Vertebral Column ◽

Rare Condition ◽

The Body ◽

Long Bones ◽

Retroperitoneal Mass ◽

Fetus In Fetu ◽

X Ray ◽

Parasitic Twin ◽

Vertebral Bodies ◽

Well Differentiated

Fetus in Fetu (FIF) is a rare condition where a monozygotic diamnionic parasitic twin is incorporated into the body of its fellow twin and grows inside it. FIF is differentiated from teratoma by the presence of vertebral column. An eight year old girl presented with an abdominal swelling which by X-ray, ultrasonography and CT scan revealed a fetiform mass containing long bones and vertebral bodies surrounded by soft tissue situated on right lumber region. On laparotomy, a retroperitoneal mass resembling a fetus of 585 gm was removed. It had a trunk and four limbs with fingers and toes, umbilical stump, intestinal loops and abundant scalp hairs but was devoid of brain and heart. Histology showed various well-differentiated tissues in respective sites. FIF is a mystery in reproduction and it is scarce in literature in such well-developed stage.

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Laparoscopic Resection of a Primary Retroperitoneal Mucinous Cystadenoma

Case Reports in Gastroenterology ◽

10.1159/000499441 ◽

2019 ◽

Vol 13 (1) ◽

pp. 159-164 ◽

Cited By ~ 2

Author(s):

Ryota Koyama ◽

Yoshiaki Maeda ◽

Nozomi Minagawa ◽

Toshiki Shinohara ◽

Tomonori Hamada

Keyword(s):

Cystic Lesion ◽

Laparoscopic Resection ◽

Mucinous Cystadenoma ◽

Primary Treatment ◽

The Body ◽

Retroperitoneal Mass ◽

Fat Tissue ◽

Imaging Studies ◽

Internal Organs ◽

Primary Retroperitoneal

Primary retroperitoneal mucinous cystadenoma (PRMC) is a rare cystic lesion occurring mostly in women with a histological analogy to ovarian mucinous cystadenoma. The tumor is difficult to detect during early stages because it causes symptoms only when it grows large enough to be palpable or to displace the adjacent internal organs. The primary treatment is resection, but the optimal surgical approach remains poorly known. We report the case of a 41-year-old woman who complained of right-sided intermittent abdominal pain. Imaging studies revealed a right retroperitoneal smooth cystic lesion (50 mm) without invasive features. Laparoscopic resection was then performed. During surgery, a right retroperitoneal mass with no connection to neighboring tissues was found. The tumor, wrapped by retroperitoneal fat tissue, was resected and removed from the body without exposure. Furthermore, histopathological findings indicated PRMC. The patient was discharged without any complications and observed to have no recurrence 6 months postoperatively.

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Dedifferentiated Liposarcoma of Retroperitoneum With Extensive Osteosarcomatous Component

International Surgery ◽

10.9738/intsurg-d-14-00282.1 ◽

2016 ◽

Vol 101 (5-6) ◽

pp. 217-221 ◽

Cited By ~ 1

Author(s):

Claudia Trombatore ◽

Caltabiano Rosario ◽

Li Destri Giovanni ◽

Magro Gaetano ◽

Petrillo Giuseppe ◽

...

Keyword(s):

Abdominal Mass ◽

Dedifferentiated Liposarcoma ◽

Caucasian Woman ◽

High Grade ◽

Retroperitoneal Mass ◽

Tissue Component ◽

Pleomorphic Sarcoma ◽

Well Differentiated ◽

High Grade Osteosarcoma ◽

Tomography Scan

Dedifferentiated liposarcoma (DDLS) is a rare subtype of liposarcoma composed of 2 components: a well-differentiated liposarcoma (WDLS) and a nonlipogenic sarcoma (dedifferentiation component), represented in >90% of cases by a high grade undifferentiated pleomorphic sarcoma, in the form of both small microscopic foci and/or grossly recognizable nodular masses. The paper reports a rare case of a retroperitoneal DDLS, in which approximately half of a tumor mass is composed of a high-grade osteosarcoma. A 68-year-old Caucasian woman affected by abdominal discomfort. Clinical examination showed a large, hard and fixed abdominal mass. Computed tomography scan revealed a huge retroperitoneal mass composed of 2 distinct components: the upper part showed a hypodense tissue, while the lower part showed a higher density and coarse calcifications. Patient underwent to a challenging surgical resection of the mass that, at histological examination, resulted to be a DDLS, in which a WDLS coexisted with an osteosarcoma. Presurgical diagnosis of DDLS is difficult due to the great morphologic variability of the dedifferentiated component, ranging from low to high-grade nonlipogenic sarcoma. The present case contributes to widen the morphological spectrum of DDLS, emphasizing the possibility that a retroperitoneal mass with a dual tissue component, one of which containing extensive areas with coarse calcifications, is highly suspected to be a DDLS with an osteosarcomatous component. This pre-operative finding should alert the surgeon because it has a significant impact on prognosis, increasing the risk of local recurrence and of death by disease in a few months after diagnosis.

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Synchronous Renal Dedifferentiated Liposarcoma and Retroperitoneal Well-Differentiated Liposarcoma: A Case Report With Literature Review

International Journal of Surgical Pathology ◽

10.1177/1066896920981682 ◽

2020 ◽

pp. 106689692098168

Author(s):

Ling Nie ◽

Xueqin Chen ◽

Jing Gong ◽

Mengni Zhang ◽

Miao Xu ◽

...

Keyword(s):

Left Kidney ◽

Final Diagnosis ◽

Dedifferentiated Liposarcoma ◽

Pathological Examination ◽

Retroperitoneal Mass ◽

Mdm2 Gene ◽

Contrast Enhanced ◽

High Grade Sarcoma ◽

Well Differentiated ◽

Enhanced Computed Tomography

Liposarcoma is the most common soft tissue malignancy and usually occurs in the retroperitoneum or the extremities but rarely in the kidney. In this article, we report a case of a 71-year-old female patient who presented with abdominal lump and left flank pain for 1 month. An abdominal contrast-enhanced computed tomography scan demonstrated a 12 cm × 7 cm solid mass arising from the upper pole of left kidney and another 8 cm × 6 cm low-density retroperitoneal mass with fat density. Radical nephrectomy of the left kidney and resection of the retroperitoneal mass were performed. Surprisingly, pathological examination revealed a high-grade sarcoma (with minor lipomatous component) in the left kidney and a retroperitoneal well-differentiated liposarcoma. MDM2 gene amplification was identified by fluorescence in situ hybridization in both tumors, supporting final diagnosis of dedifferentiated liposarcoma of the kidney and well-differentiated liposarcoma of the retroperitoneum.

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Invasive potential of retroperitoneal well-differentiated liposarcomas depending on the extent of sclerosing component in the tumor

Russian Journal of Oncology ◽

10.17816/1028-9984-2020-25-2-50-55 ◽

2020 ◽

Vol 25 (2) ◽

pp. 50-55

Author(s):

A. Yu. Volkov ◽

N. A. Kozlov ◽

S. N. Nered ◽

I. S. Stilidi ◽

A. M. Stroganova ◽

...

Keyword(s):

Long Term Results ◽

Federal State ◽

Invasive Potential ◽

Morphological Marker ◽

Favorable Prognosis ◽

National Medical ◽

Well Differentiated ◽

Organ Invasion ◽

Primary Retroperitoneal

Objective. To assess the influence of the extent of sclerosing component in the retroperitoneal well-differentiated liposarcoma (WDLPS) on the survival. Material and methods. The retrospective study included 111 patients with primary retroperitoneal WLPS who underwent radical surgical treatment in Federal State Budgetary Institution N.N. Blokhin National Medical Research Center of Oncology. Histological slides of all surgical specimens were reviewed by experienced pathologist and reclassified according to criteria of WHO (2013). Patients were divided into groups depending on the extent of the sclerosing component in the tumor and enrolled in intergroup analysis. We analyzed relationship between extent of the sclerosing component in the tumor and frequency of the pathologically confirmed visceral invasion. Also, we have analyzed the influence of the visceral invasion of WDLPS on the long-term results overall (OS) and recurrence-free (RFS) survival. Results. Pathologically confirmed visceral invasion was revealed in 17% of cases with the sclerosing component less 20%, and in 31% of cases with the sclerosing component more 20%. OS was significantly worse in the group of patients who suffered from WDLPS with visceral invasion than in the group of patients without visceral invasion (p = 0.009; logarithmic criterion). The median OS in the compared groups was 85 (95% CI, 84, 87) and 142 (95% CI, 109, 175) months, the 5-year OS rate was 41% and 86%, respectively. RFS was significantly worse in the group of patients with histologically confirmed visceral invasion than in the group without organ invasion (p = 0.001; logarithmic criterion). Median RFS in the compared groups was 26 (95% CI, 20, 32) and 57 (95% CI, 38, 76) months, 2-year RFS 33% and 85%, respectively. Conclusion. Results of the study demonstrate more aggressive behavior of WDLPS with increasing extent of the sclerosing component. We believe that semi-quantitative counting of sclerosing component in retroperitoneal WDLPS can serve as an effective morphological marker of a less favorable prognosis of the disease.

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