Laparoscopic Liver Resection for Metastasis of Retroperitoneal Leiomyosarcoma

Abstract

Introduction Soft tissue leiomyosarcomas represents 0.7% of all malignant tumors. The most common location is the retroperitoneum, and the appearance of local or distant recurrences after resection is not uncommon. Pathological study is important to establish the confirmatory diagnosis and the prognosis of this type of lesion. Clinical case We present the clinical case of a patient with retroperitoneal leiomyosarcoma that was resected associated with ipsilateral nephrectomy. An 11-month follow-up revealed a hepatic lesion in segment 5, suggestive of metastasis. We decided on surgical resection of this lesion. Liver segmentectomy was performed by laparoscopic approach. The pathological study of the liver lesion showed a tumor of about 5 centimeters, compatible with leiomyosarcoma metastasis, presenting abundant mitoses (8/10), 15% necrosis in the central area and a Ki67 of 20%. Discussion Leiomyosarcoma is a very aggressive tumor. Its treatment is fundamentally based on the surgical resection of the primary and its possible metastases. The pathological study of the piece, with special emphasis on the number of mitoses, as well as the Ki- 67%, are indicators of the aggressiveness of the tumor and the prognosis. Given the low incidence of these tumors, it is recommended that the approach of these tumors be done in multidisciplinary teams and in specialized centers.