Dedifferentiated liposarcoma of the colon causing obstruction: A case report

Dedifferentiated liposarcoma (DDLPS) of the colon is an uncommon, aggressive malignancy that poses diagnostic and therapeutic challenges. We present the case of a 57-year-old male who presented with a large bowel obstruction and melena. Imaging and colonoscopy revealed a large , near-obstructing mass at the splenic flexure. He underwent an exploratory laparotomy with left colectomy; intraoperative hemorrhage from splenic vein avulsion required vascular repair and splenectomy. Final pathology demonstrated a grade 3 DDLPS with MDM2 amplification, negative margins, and no nodal involvement. Two months after discharge, he developed extensive peritoneal sarcomatosis and pulmonary metastases and eventually elected for hospice care. This rare presentation of colonic DDLPS underscores the difficulty of preoperative diagnosis, the potential for locally invasive behavior with complex intraoperative management, and the rapid metastatic progression that can occur despite complete macroscopic resection.