Clinicopathological characteristics and experience in the treatment of giant retroperitoneal liposarcoma: A case report and review of the literature

Abstract

Retroperitoneal liposarcoma (RPLS) is a rare tumor, especailly those over 20 kg that are called "giant liposarcoma," whose characteristics and treatments remain relatively unknown. Herein, we report a giant RPLS measuring 65 × 45 × 30 cm in diameter and 31 kg in weight, which we successfully performed complete excision through interdisciplinary cooperation. The patient had an uneventful postoperative course and was discharged without complications. Afterwards he underwent radiotherapy and had no evidence of tumor recurrence or symptoms of metastasis at 3-month CT scan and 8-month follow-up. We also first review the 13 cases reported in literature published in PubMed regarding giant RPLS. Giant RPLS commonly occurs in adults aged 40-60 y and presents atypical clinical manifestations. CT scan is the most useful examination and preoperative biopsy is controversial. Complete surgical resection still remains the principal treatment. Giant RPLS can also be removed, even reach to R0 excision, by a multidisciplinary team in a specialized center after meticulous planning even though its gigantic tumor size. Local radiotherapy following surgery may improve the rate of recurrence. Besides, closely follow-up and routine examinations are required.

Giant retroperitoneal liposarcoma: A case report and literature review

“…In their cohort of 500 patients with RPS, the median survival after an R0 resection was 103 months compared to 18 months after an R1 or R2 resection. In a review by Zeng et al., the long-term 5- and 10-year survival rates without complete resection were described as 16.7% and 8.0%, respectively 22 . This reaffirms the curative role of surgical excision of RPS.…”

Management of Giant Retroperitoneal Liposarcoma: A Case Report

“…In another study, 3 and 5-year survival rates of patients who underwent complete resection were reported as 73% and 60%, respectively [10]. Long-term prognosis is poor in patients without complete resection and 5-, and 10-year survival rates are 16.7% and 8%, respectively [11].…”

“…However, chemotherapy has been suggested, but it has worsened patient's prognosis [10]. The effectiveness of postoperative radiotherapy has been inquired in local control rather than overall survival [11]. Ballo et al also stated that radiotherapy was ineffective in RPLS cases and radiotherapy applied may cause neuropathy, hydronephrosis, fistula and ileus [15].…”

A Giant retroperitoneal liposarcoma encasing entirely the right kidney: A case report and a review of nephrectomy indications

“…In fact, complete surgical resection is the cornerstone of non-metastatic RLS treatment. Furthermore, R0 resection is the most consistent prognostic factor [5] .…”