Thoughts and challenges of giant retroperitoneal liposarcoma: A case report

BACKGROUND: Retroperitoneal liposarcoma (RPLS) is a rare malignant tumor initiated in adipocytes. It is discovered only when the tumor is large because of its deep anatomical location and insidious onset. Giant RPLS with a diameter exceeding 30 cm is extremely rare. Its diagnosis and treatment present extremely great challenges. CASE SUMMARY: The patient, a 62-year-old woman, presented to the hospital complaining of abdominal distension for more than six months. Imaging examination revealed a large retroperitoneal mass. Finally, the patient was diagnosed with giant RPLS. The tumor occupied the entire abdominal cavity, severely compressed the abdominal organs, and adhered tightly to the bilateral ureters. After careful preoperative preparation (including three-dimensional visualization and bilateral ureteral stent implantation), we performed resection of the large retroperitoneal mass. The tumor was completely removed and consisted of multiple masses, with a total weight of 17 kg and the largest mass size of 35 cm × 28 cm × 14 cm. Postoperative pathological results revealed that the mass was a well-differentiated liposarcoma. The patient recovered well after surgery, and there was no sign of recurrence after 2 months of follow-up. CONCLUSION: Surgical resection is the only radical treatment for giant RPLS. Preoperative preparation is essential, and three-dimensional visualization reconstruction is helpful for the formulation of surgical plans. Postoperative radiotherapy and neoadjuvant therapy can be reasonably selected, but whether they can reduce the recurrence rate is still controversial.