PMC6446056_01
CT abdominal scan showed a voluminous solid oval mass (11.2 cm x 7.5 cm x 12 cm) in the left perirenal space with dislocation of the kidney and in continuity with the anterior renal fascia. After iodinated-contrast we observed a progressive, inhomogeneous enhancement of the lesion with peripheral vascularization.
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After iodinated-contrast we observed a progressive, inhomogeneous enhancement of the lesion with peripheral vascularization (Fig. 1).
a) Laparoscopic dissection of adiposes cleavage planes with the left colon and the others surrounding peritoneal organs; b) retroperitoneal space after surgical resection: we can identify spleen and preserved pancreatic tail, clipped left renal vein and artery; c) surgical specimen with in block resection of left kidney, adrenal gland and DD liposarcoma; d) DD liposarcoma appeared oval, 13 x 11 x 9 cm of size, with a smooth surface and regular margins.
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The dissection was done with Harmonic scalpel  (Ethicon Endo Surgery INC - Johnson & Johnson, NJ, USA) from up-to-down until the left renal artery and vein and the ureter were clipped and divided with the aim to perform an in block resection of left adrenal gland, kidney and DD liposarcoma with safety margins adequate for neoplasm resection (Fig. 2a and b). Macroscopically the mass appeared oval, 13 x 11 x 9 cm of size, with a smooth surface coated with a greyish capsule and with regular margins (Fig. 2c and d).