Uncommon Presentation Of A Giant Retroperitoneal Liposarcoma: A Peculiar Case Study

Abstract

Introduction: Soft tissue sarcomas constitute less than 1% of all neoplasms, with approximately one-third of malignant tumors in the retroperitoneum being sarcomas. Among these, liposarcoma emerges as the most prevalent type. Retroperitoneal liposarcomas with intraperitoneal extension and extension into the inguinal canal are relatively uncommon, presenting a challenge for treatment due to their local aggressiveness and clinical nonspecificity. The clinical difficulty in managing these cases is exacerbated by patients often seeking medical attention late in the disease progression. The slow development and the scarcity of symptoms in the early stages contribute to delayed reporting. Consequently, these tumors are recognized for their capacity to reach enormous sizes before being diagnosed and addressed. Case Report: We present a case involving a 52-year-old man who underwent surgical resection for a massive, well-differentiated retroperitoneal liposarcoma. This tumor exhibited intraperitoneal extension and weighed a substantial 6.8 kilograms. Discussion: Retroperitoneal liposarcomas (RPS) frequently manifest as large, locally advanced lesions. The occurrence of RPS with intraperitoneal extension and extension into the inguinal canal is relatively uncommon. The clinical presentation is often delayed, attributed to the expansive nature of the retroperitoneal space. Evaluating these tumors necessitates a comprehensive, multimodal approach. Given that most RPS are characterized as low-grade, distant metastasis is infrequent, and the primary challenge lies in achieving effective local control and preventing recurrence. The preferred treatment involves radical resection of these tumors, incorporating en bloc resection of involved structures. In certain cases, the strategic use of neoadjuvant and adjuvant therapies, tailored to specific tumor histologies, may enhance local control and overall survival. Conclusion: Effectively managing retroperitoneal liposarcomas necessitates a multidisciplinary approach, ideally conducted at high-volume centers that specialize in the treatment of patients facing these intricate malignancies. Existing data indicate that radical resection stands as the primary opportunity for a cure. In select cases, chemotherapy and radiation therapy may offer a survival benefit, underlining the importance of individualized treatment strategies based on the specific characteristics of the tumor and the patient