El-Helou Etienne, Alimoradi Mersad, Sabra Hassan, Naccour Jessica, Haddad Marwan M, Bitar Henri
General Surgery Department, Faculty of Medical Sciences, Lebanese University, Mount Lebanon, Lebanon.
Emergency Medicine Department, Faculty of Medical Sciences, Lebanese University, Mount Lebanon, Lebanon.
Int J Surg Case Rep. 2020;75:504-512. doi: 10.1016/j.ijscr.2020.09.143. Epub 2020 Sep 23.
This case is of a patient with a recurrent giant retroperitoneal liposarcoma, followed-up and operated multiple times over 10 years. We report this case because of its rarity and review all previous articles reporting "Giant Retroperitoneal Liposarcoma" in the English literature.
A 70 years old man presented to our clinic for dizziness and fatigue. He was incidentally found to have a large retroperitoneal mass filling all the length of the abdominal cavity and shifting all intraabdominal viscera and kidney to the left side. En bloc excision of a 50 × 30 × 18 cm, 9 kg tumor was performed. Final pathology revealed a well-differentiated liposarcoma. Five years later, the patient was reoperated for recurrence and a well-differentiated liposarcoma was excised in 2 pieces (the biggest measuring 14 × 11 × 7 cm) along with the appendix. Four years later the patient was operated on again for a second recurrence, and again a well-differentiated liposarcoma (16 × 10 × 7 cm) extending into the right inguinal canal was excised. One year thereafter, the patient was diagnosed with a third recurrence (22 × 12 cm).
Retroperitoneal Liposarcomas are rare tumors, presenting with different histological differentiation. They are diagnosed using multiple imaging modality, mainly CT scan, and it is confirmed by percutaneous large core needle biopsy. R0 Surgical excision remains the proper treatment for non-metastatic tumors, which may necessicate multiorgan resection. They rarely grow to reach a large size and be labled as "Giant Retroperitoneal Liposarcoma".
本病例为一名复发性巨大腹膜后脂肪肉瘤患者，在10多年间接受了多次随访及手术。我们报告此病例是因其罕见性，并回顾了英文文献中所有报道“巨大腹膜后脂肪肉瘤”的既往文章。
一名70岁男性因头晕和疲劳前来我院就诊。偶然发现其腹膜后有一巨大肿块，占据整个腹腔长度，将所有腹腔内脏器和肾脏推移至左侧。进行了整块切除，肿瘤大小为50×30×18 cm，重9 kg。最终病理显示为高分化脂肪肉瘤。5年后，患者因复发再次手术，切除了2块高分化脂肪肉瘤（最大块为14×11×7 cm），并切除了阑尾。4年后，患者再次因第二次复发接受手术，又切除了一个延伸至右侧腹股沟管的高分化脂肪肉瘤（16×10×7 cm）。此后1年，患者被诊断为第三次复发（22×12 cm）。
腹膜后脂肪肉瘤是罕见肿瘤，具有不同的组织学分化。通过多种影像学检查手段进行诊断，主要是CT扫描，并经皮粗针穿刺活检确诊。对于非转移性肿瘤，R0手术切除仍然是合适的治疗方法，这可能需要多器官切除。它们很少生长到很大尺寸并被称为“巨大腹膜后脂肪肉瘤”。
