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Santangelo A, Fernicola A, Santangelo D, Peluso G, Calogero A, Crocetto F, Jamshidi A, Pelosio L, Scotti A, Tammaro V, Tranquillo V, Tammaro D, De Cocinis C, Della Gaggia F, Capezio E, Carlomagno N, Santangelo M. Dark Topics on Giant Retroperitoneal Liposarcoma: A Systematic Review of 157 Cases. Cancers (Basel) 2025; 17:740. [PMID: 40075588 PMCID: PMC11899555 DOI: 10.3390/cancers17050740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 02/17/2025] [Accepted: 02/19/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND/OBJECTIVES Giant Retroperitoneal Liposarcomas (giant RPLs) represent a rare malignant disease of adulthood that does not yet have a univocal definition in the scientific literature. The symptoms may be late, depending on the position and the size reached. The weight may exceed 20 kg, and the diameter 25 cm. The main treatment is the surgical approach. This systematic review aims to collect data from the present literature and to answer some questions on the nature of this pathology. METHODS We performed a search on the PubMed, Cochrane, and Scopus databases using specific search strings. Non-English written articles and abstracts were excluded. RESULTS Dimensional, histological, and pathological data of giant RPLs were extracted and recorded in an electronic database, and charts were used to synthesize the results. We selected 126 manuscripts, all case reports and case series, and obtained data for 157 giant RPLs. The major axis varied from 15 to 80 cm, and the weight ranged between 2.5 and 98 kg. Sex distribution was homogenous. Age was reported 146 times, and almost 1/3 of the study population was under 50 years old. The most frequent hystotype reported was well-differentiated liposarcomas, while the rarest was pleomorphic liposarcomas. In 139 cases, the symptoms were reported and generally included a mass effect on surrounding organs. The exclusive surgical operation was the most frequent treatment option, and it included both the resection of the tumor and other organs involved. Chemo- and radiotherapy were also performed, in a few cases. In 36 reports, distant metastasis was suspected, but only 6 were effectively positive. CONCLUSIONS Giant RPLs are a clinical entity that shares some common features with normal-size liposarcomas but are different in dimensions, age distribution, histologic prevalence, rate of incidental diagnosis, organ sparing, and R0 resection. More studies are needed to completely characterize these tumors.
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Affiliation(s)
- Alfonso Santangelo
- Unit of Urology, Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Agostino Fernicola
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Domenico Santangelo
- Department of Radiology, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy;
- Surgical and Biomorphological Sciences PhD, Federico II University, 80138 Naples, Italy
| | - Gaia Peluso
- Department of General Surgery, Fatebenefratelli Hospital of Naples, 80123 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Felice Crocetto
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy;
| | - Akbar Jamshidi
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Luigi Pelosio
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Alessandro Scotti
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Vincenzo Tammaro
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Valentina Tranquillo
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Dario Tammaro
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Carmen De Cocinis
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Francesca Della Gaggia
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Emanuela Capezio
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Nicola Carlomagno
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, Unit of Emergency Surgery, Federico II University, 80131 Naples, Italy; (A.C.); (A.J.); (L.P.); (A.S.); (V.T.); (N.C.); (M.S.)
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