A 24-kilogram retroperitoneal liposarcoma surgical management: A case report

Sarcomas are diverse malignant tumors originating from soft tissues (STS) or bones, with STS being more prevalent. Liposarcoma is the most common type of STS, typically arising in the extremities and retroperitoneum. This case report discusses the management of a rare, giant retroperitoneal liposarcoma (RL) in a 47-year-old man presented with significant abdominal enlargement, post-pharyngeal discharge, and urinary dribbling. Medical history included an inguinal hernia and smoking. Diagnosis through imaging (sonography, CT, MRI) and biopsy confirmed a well-differentiated liposarcoma encasing the left kidney and compressing abdominal organs. The tumor measured 53 × 47 x 20 cm and weighed 24 kg. Surgical management included complete tumor excision, left nephrectomy, iliac artery repair, colectomy, and lymph node dissection. The management of RL is challenging due to its size and proximity to vital organs. Complete surgical resection is crucial for recurrence-free survival. Preoperative radiotherapy can aid in achieving negative margins by defining target volumes and reducing irradiation of adjacent tissues. Chemotherapy is reserved for high-grade tumors with metastatic potential. This report highlights the complexities of managing giant RL, underscoring the importance of thorough surgical planning, multidisciplinary collaboration, and assessing potential adjunct therapies to improve patient prognosis.