Giant retroperitoneal liposarcoma: Case report and review of the literature

• The origin from perirenal fat is very uncommon.
• The occurrence of hematogenous metastasis is a rare finding at the time of diagnosis.
• The undifferentiated and pleomorphic type are neoplasm with high grade of malignancy.
• In case of diagnostic doubt and in presence of recurrence, magnetic resonance imaging (MRI) may be useful because can identifying in a reliable manner the satellite localizations of the main lesion.
• The complete surgical (R0) resection represents the only possibility of radical treatment.
• Following surgical resection, the 50–100% of liposarcomas recur from residual tissue, which is the primary cause of death.
• Percutaneous biopsy has low accuracy in the diagnosis of retroperitoneal dedifferentiated liposarcoma (DDLS).

AimRetroperitoneal soft-tissue sarcomas are relatively uncommon diseases, the most frequent histotype, ranging from 20% to 45% of all cases, is represented by liposarcoma, which is a hard-to treat condition for its local aggressiveness and clinical aspecificity.Presentation of caseWe report a case of a 64-years-old woman who underwent surgical resection for a giant pleomorphic retroperitoneal liposarcoma.DiscussionCurrently chemotherapy for retroperitoneal soft-tissue sarcomas is no effective, and radiotherapy has limited efficacy due to the toxicity affecting adjacent intra-abdominal structures, showed validity only in case of high-grade malignancy by reducing local recurrence, but with no advantage in overall survival. Nowadays only, the complete surgical resection remains the most important predictor of local recurrence and overall survival.ConclusionThe removal of a retroperitoneal sarcoma of remarkable size is a challenge for the surgeon owing to the anatomical site, to the absence of an anatomically evident vascular-lymphatic peduncle and to the adhesions contracted with the contiguous organs and with the great vessels. Therefore, we believe that, particularly for large-size diseases associated to high-grade malignancy, a complete surgical resection with removal of the contiguous intra and retroperitoneal organs when infiltrated represents the only therapeutic option to obtain a negative margin and therefore an oncological radicality.