PMC7530305_01
CT scanner and MRI: 450 x 250 mm right retroperitoneal liposarcoma pushing the kidney and bowels to the other side.
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No invasion of nearby structures was mentioned (Fig. 1, Fig. 2).
Intraoperative photo: Midline laparotomy with bulging of the mass.
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A midline incision extending from the subxiphoid to the suprapubic area was then done (Fig. 3).
Intraoperative Photo: Excision of the retroperitoneal mass en block.
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After reaching the retroperitoneal space and identification of the limits of the tumor, en bloc removal was achieved after liberating it from the surrounding structures followed by lymph node harvesting (Fig. 4).
Intraoperative Photo: Giant Liposarcoma excised en block.
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The mass weighed 9 kg and measured 50 x 30 x 18 cm (Fig. 5).
Well-differentiated liposarcoma, mature adipocytes and atypical cells (x100).
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Microscopically, the tumor showed lobulated neoplastic proliferation made up of mature adipose cells of variable size with some hyperchromatic and irregular nuclei (Fig. 6, Fig. 7).
PET-CT Scan of the abdomen and pelvis: No FDG enhancement.
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CT scanner and MRI: Recurrence of the right retroperitoneal liposarcoma (Blue Arrow) encapsulating the right renal vessels.
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It is extending anteriorly to the pre-aortic space and left anterior para-renal space, displacing the pancreas and the viscera anteriorly with no sign of invasion (Fig. 9).
Timeline.
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