EP.TH.96Recurrent Retroperitoneal Liposarcoma Presenting as Irreducible Inguinal Hernia

Abstract

Abstract Introduction Retroperitoneal sarcomas protruding though the groin are extremely rare with only about 12 cases reported in the past 31 years to our knowledge. . As the retroperitoneal space communicates with the inguinal canal, large lipomatous tumors, may protrude through this natural weak spot which may present as irreduciible inguinal hernia. Case Report We report a 43 year old male, previously operated for retroperitoneal liposarcoma with 4 cycles of adjuvant chemotherapy and 5 cycles of radiotherapy 4 years back now presented with irreducible inguinal hernia. On examination, a firm fixed mass of about 15 x 10 cm, with indistinct margins was palpable in right hemiabdomen, abdomen was soft with audible bowel sounds. A firm swelling of 8 x 5 cm in right inguinal region extending into scrotum with no cough impulse was also present. On CT imaging a large mixed density lesion noted in Right lower abdomen measuring 16.2 x 14.8 x 23.5 cm. It showed internal fat and solid components and recurrence with herniation through right inguinal canal which is a rare entity. The patient was treated symptomatically, bilateral DJ stenting was done by the urology team and the patient was prepared for debulking surgery. Patient was classified as ASA IV. Unfortunately, the patient died 6th post admission day secondary to cardiopulmonary arrest. Conclusion A retroperitoneal tumor especially a liposarcoma should be ruled out in a large, painless, non-reducible inguinal mass with abdominal complaints. Patients need regular follow up after resection of retroperitoneal liposarcoma for early detection of recurrence.