PMC4392328_01
CT scan showing the presence of the bulky lesion stretching from the subhepatic region to the pelvic cavity, displacing the right kidney to the left.
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The computed tomography (CT) of the abdomen demonstrated the presence of a voluminous mass, extending from the sub-hepatic space up to the pelvic cavity with dislocation of the right kidney to the left (Figs. 1 and 2).
CT scan showing the macroscopic intralesional characteristics, consisting of the presence of areas with different fat density and thick septa associated with an inhomogeneous solid component featuring sovrafluid-density coarse components.
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The computed tomography (CT) of the abdomen demonstrated the presence of a voluminous mass, extending from the sub-hepatic space up to the pelvic cavity with dislocation of the right kidney to the left (Figs. 1 and 2).
Evidence of the close relationship between the lesion and the right kidney and the origin from the right retroperitoneal region at the level of the ipsilateral parietocolica space.
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For the apparent infiltration of the right kidney (Fig. 3) was performed a biopsy that confirmed its neoplastic infiltration.
Right retroperitoneal cavity as it appeared once the lesion had been removed and the right nephrectomy had been performed, with evidence of the structures that had close relations of contiguity with it. The inferior vena cava is easily recognizable as well as the iliopsoas muscle, gonadal blood vessels and right iliac vessels.
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We proceeded to release the neoplasm from the adhesions by retroperitoneal contiguous organs including the vena cava and common iliac vessels, with its subsequent removal en bloc with the right kidney (Fig. 4).
Picture of the removed surgical specimen including the right kidney.
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The definitive histological diagnosis was pleomorphic liposarcoma with myxoid areas, (42 x 37 x 18 cm) (Fig. 5), originating from the right perirenal fat and infiltrating the periureteral tissue, with free resection margin.