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AlBathi AK, Mashhor YM, Muharib AA, Altawili AA. Intraperitoneal Liposarcoma: A Case Report and Literature Review of a Rare Entity. Cureus 2024; 16:e59244. [PMID: 38813304 PMCID: PMC11134115 DOI: 10.7759/cureus.59244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/31/2024] Open
Abstract
Liposarcoma is a rare soft-tissue neoplasm originating from adipocytes. The exact cause of liposarcoma is unknown and symptoms vary depending on the tumor's location. A 49-year-old man presented to the emergency room complaining of epigastric pain radiating to the back and right upper quadrant. Cross-sectional imaging revealed a large upper abdominal mass that was thought to be a gastrointestinal stromal tumor (GIST) arising from the duodenum at first. The patient underwent en-bloc resection of the mass and was planned for adjuvant chemotherapy. Subsequently, multiple tissue samples were examined, leading to the final diagnosis of de-differentiated liposarcoma. The patient eventually developed multiple recurrences and was subjected to re-resection surgeries and three different chemotherapy regimens. Given the rarity of the disease, no standardized therapy plan is available, highlighting the need for more case reports/series and trials to broaden our understanding of this disease.
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Narita K, Kaneko H, Hasegawa F, Akao N, Kusafuka T, Desaki R, Ogura M, Hamada T, Asakawa K, Murata T. A giant liposarcoma originating from peripancreatic fat tissue with identification using 3D-CT angiography: a case report. Surg Case Rep 2024; 10:7. [PMID: 38185749 PMCID: PMC10772136 DOI: 10.1186/s40792-023-01797-3] [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: 10/23/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Liposarcoma originating from peripancreatic fat tissue is extremely rare. This case report presents a surgical case of a giant liposarcoma originating from peripancreatic fat tissue with origin identification using 3-Dimensional Computed Tomography Angiography (3D-CTA). CASE PRESENTATION A 59-year-old female was referred to our hospital with a giant abdominal tumor. Computed tomography revealed a 34 cm tumor composed of fatty tissue, exerting pressure on the posterior aspect of the pancreas. Suspecting liposarcoma, we planned for surgery. At first, the tumor appeared to be intra-abdominal tumor, based on the identification of the tumor's feeding artery as a branch of the dorsal pancreatic artery using 3D-CTA, we concluded that the liposarcoma originated from the peripancreatic fat tissue and situated in the retroperitoneum. During surgery, we observed a well-capsulated, elastic, yellowish mass without infiltration into surrounding tissues. We carefully dissected the tumor from the greater omentum and transverse mesocolon while preserving the tumor capsule. We ligated the feeding artery at the border with the pancreatic parenchyma and successfully completed the excision of the tumor. The resected specimen weighted 2620 g and was pathologically diagnosed as a well-differentiated liposarcoma. There was no injury to the tumor's capsule, and the surgical margins were negative. CONCLUSIONS In this report, we present an extremely rare case of a liposarcoma originating in the peripancreatic fat tissue. The use of 3D-CTA was instrumental in identifying the primary site of this giant tumor, enabling us to guide the surgery and achieve complete resection successfully.
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Affiliation(s)
- Kiyoshi Narita
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan.
| | - Hiroshi Kaneko
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Fumiya Hasegawa
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Nozomi Akao
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Tomoki Kusafuka
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Ryosuke Desaki
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Masaomi Ogura
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Takashi Hamada
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Kana Asakawa
- Department of Pathology, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Tetsuya Murata
- Department of Pathology, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
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Ghahremani GG. CT and MR imaging of the greater omentum: Pictorial essay. Clin Imaging 2023; 101:22-31. [PMID: 37290177 DOI: 10.1016/j.clinimag.2023.05.014] [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: 04/10/2023] [Revised: 05/17/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
The greater omentum is a unique anatomical structure that serves a critical function in the containment of inflammatory and infectious processes within the abdominal cavity. It is also a common site of involvement by metastases, as well as the primary location for various pathologic lesions of clinical significance. Its fibroadipose composition, large size, and position in the most anterior aspect of abdomen allow accurate visualization of the greater omentum on CT and MR images. Careful evaluation of the greater omentum can provide important clues to the diagnosis of the underlying abdominal disorder. The aim of this article is to present the normal appearance of the greater omentum, and the wide spectrum of its pathological features as demonstrated on CT and MRI of the abdomen.
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Affiliation(s)
- Gary G Ghahremani
- Department of Radiology, University of California-San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA.
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Giant mesenteric myxoid liposarcoma: Challenges of diagnosis and treatment. Radiol Case Rep 2022; 17:4227-4231. [PMID: 36120521 PMCID: PMC9471334 DOI: 10.1016/j.radcr.2022.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022] Open
Abstract
Myxoid liposarcoma is the most frequent form of liposarcoma, frequently localized in the extremities. Abdominal liposarcomas more commonly arise from the retroperitoneum. However, primary mesenteric localization is extremely rare. To the best of our knowledge, 22 cases have been reported in English literature. The diagnosis is often delayed by the insidious evolution of this tumor. On radiological examination, primary mesenteric liposarcoma presents as a large mass that entrapped the small bowel loops. The treatment requires complete tumor resection. We report an observation of mesenteric myxoid liposarcoma in a 64-year-old female patient, revealed by an abdominal mass associated with abdominal pain. The treatment consisted of complete tumor removal. Histologically, the tumor proved to be a myxoid liposarcoma. No adjuvant treatment was considered necessary. The patient recovered well after the operation. The aim of reporting this case is to present an uncommon clinical entity because of its huge dimensions, the rarity of the site, and histological pattern.
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Luke ND, Gart A, Mohammad R, Raza A. Liposarcoma: A ‘Beer Belly’ in Disguise. Cureus 2022; 14:e28067. [PMID: 36120215 PMCID: PMC9477226 DOI: 10.7759/cureus.28067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/26/2022] Open
Abstract
Liposarcoma is a locally aggressive tumor that may originate in soft tissue sites such as the retroperitoneum or the extremities, or less frequently, from the bone. The fatty tumor may have an insidious growth pattern and be present incidentally on imaging, or it may be present with symptoms such as small bowel or ureter obstruction. The diagnosis can be confirmed post-operatively via fluorescence in situ hybridization (FISH) with the presence of mouse double minute 2 (MDM2) homolog protein and cyclin-dependent kinase 4 (CDK4) gene amplification. The rate of recurrence may be high depending on the subtype of liposarcoma, so it is always recommended to have the patient undergo routine imaging every six months to a year. In this case report, we present a patient who presented with a massive, incidental liposarcoma found on imaging after coming to the emergency department for lower extremity trauma.
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Li JXJ, Giddings HL, Owen G. Omental lipoma: a rare cause of a giant intra-abdominal mass. J Surg Case Rep 2022; 2022:rjac160. [PMID: 35481249 PMCID: PMC9038225 DOI: 10.1093/jscr/rjac160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/23/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Primary tumors of the omentum, let alone omental lipomas, are rare causes of a large intra-abdominal mass. We report a case of an adult male presenting with an intra-abdominal mass, representative of a giant omental lipoma radiologically, confirmed on histopathology after complete resection at laparotomy. The case highlights the preoperative workup of a suspected omental lipoma, including the utility of various radiological modalities in differentiating from malignant pathologies, and anatomical characterization of the lesion for surgical planning.
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Affiliation(s)
- Jia Xi Julian Li
- Department of Surgery, St Vincent’s Hospital Sydney, Darlinghurst, New South Wales, Australia
| | - Hugh Lewis Giddings
- Department of Surgery, St Vincent’s Hospital Sydney, Darlinghurst, New South Wales, Australia
| | - Gareth Owen
- Department of Surgery, St Vincent’s Hospital Sydney, Darlinghurst, New South Wales, Australia
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Shivkumar VB, Atram M, Deshmukh A, Gangane N. Intraperitoneal dissemination of primary dedifferentiated liposarcoma of omentum simulating an ovarian cancer – A case report. Indian J Cancer 2022; 59:422-425. [DOI: 10.4103/ijc.ijc_1128_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wang S, Han X, Liu S, Xu G, Li J. Primary retroperitoneal liposarcoma: a rare case report. J Int Med Res 2021; 49:3000605211063085. [PMID: 34878928 PMCID: PMC8664316 DOI: 10.1177/03000605211063085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/10/2021] [Indexed: 01/20/2023] Open
Abstract
Primary retroperitoneal liposarcoma (PRPLS) is a rare malignant tumor with a low incidence. A 34-year-old female patient presented to our department with abdominal pain, nausea, and vomiting for 2 days. Abdominal computed tomography (CT) indicated a huge mass between the liver and kidney, with a clear boundary and measuring approximately 202 mm × 155 mm ×106 mm. The mass was considered a retroperitoneal lipoma or liposarcoma. The entire tumor was completely resected without auxiliary injury, and histopathology of the resected specimen indicated liposarcoma. The patient recovered well and was discharged from our department on the 6th postoperative day. No signs of relapse were seen during 1-year of follow-up. PRPLS is rare and without obvious symptoms in the early stage. CT plays a vital role in the diagnosis of PRPLS, and surgical resection is considered the most suitable treatment. Radiotherapy and chemotherapy might also be treatment options to improve the overall survival of PRPLS patients.
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Affiliation(s)
- Shu Wang
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun Jilin, China
| | - Xu Han
- Department of General Surgery, The Second Hospital of Jilin University, Changchun Jilin, China
| | - Shiyang Liu
- Department of Vascular Surgery, The Second Hospital of Jilin University, Changchun Jilin, China
| | - Guangmeng Xu
- Department of General Surgery, The Second Hospital of Jilin University, Changchun Jilin, China
| | - Jiannan Li
- Department of General Surgery, The Second Hospital of Jilin University, Changchun Jilin, China
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Liu JY, Li SQ, Yao SJ, Liu Q. Omental mass combined with indirect inguinal hernia leads to a scrotal mass: A case report. World J Clin Cases 2021; 9:7850-7856. [PMID: 34621837 PMCID: PMC8462230 DOI: 10.12998/wjcc.v9.i26.7850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/06/2021] [Accepted: 08/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary omental tumors are uncommon, and omental fibromas account for 2% of these tumors. Due to the low incidence of omental fibromas and the limited relevant literature, it is challenging for clinicians to make an accurate diagnosis of this condition, especially before surgery.
CASE SUMMARY A 30-year-old man was admitted to the hospital because of a left epididymal mass with vague discomfort for more than 1 mo. A physical examination was performed, and the findings showed that the epididymal mass may have entered the abdominal cavity. Pelvic computed tomography was performed in our hospital and revealed a left inguinal hernia with a mass in the hernial contents, and no masses were found in the left epididymis. A traditional inguinal hernia incision was made. Intraoperative hernia contents were found to be of the greater omentum, and a 2.5 cm-diameter mass was found at the distal end of the greater omentum. The scrotum and epididymis did not exhibit other masses. Then, the mass of the greater omentum was excised. Intraoperative frozen pathological examination suggested a spindle cell tumor. The postoperative pathological examination suggested that the mass was an omental angiofibroma. Postoperatively, the patient recovered well and was discharged. Outpatient re-examinations were performed at 1 mo and half a year after the operation and showed no obvious abnormalities.
CONCLUSION Due to the low morbidity rate associated with and latent nature of omental tumors, these tumors are difficult to diagnose preoperatively; thorough medical history taking, detailed physical examinations, and necessary imaging auxiliary examinations can help clinicians diagnose and treat these cases.
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Affiliation(s)
- Jia-Yi Liu
- Department of Urology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
| | - Shuai-Qi Li
- School of Medicine, Nankai University, Tianjin 300192, China
| | - Shi-Jie Yao
- Department of Urology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
| | - Qian Liu
- Department of Urology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
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Terai T, Nakagawa K, Nakamura K, Doi S, Morita K, Ohbayashi C, Sho M. Neuroendocrine tumor arising from the greater omentum treated with laparoscopic tumor resection: a case report. Surg Case Rep 2021; 7:132. [PMID: 34061282 PMCID: PMC8167924 DOI: 10.1186/s40792-021-01217-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Primary omental tumors are extremely rare. Herein, we report the first case of a primary omental neuroendocrine tumor (NET). Case presentation A 59-year-old woman was referred to our hospital for the treatment of an 18-mm tumor located at the ventral side of the duodenum. No other tumor was detected. The preoperative imaging diagnosis was omental tumor. A laparoscopic tumor resection was performed. Histopathological examination revealed that the tumor consisted of cuboidal cells with eosinophilic, granular cytoplasm showing trabecular or ribbon architecture. No other component was seen. The mitotic count was of 5 per 10 high-power fields. Immunohistochemical staining was positive for chromogranin A, synaptophysin, and CD56. Her Ki-67 index was 5%. These results led to the diagnosis of grade 2 omental NET. The patient was discharged on the 3rd postoperative day without any complications and did not develop any recurrence for 3 years. Conclusions We encountered a very rare case of omental NET. Complete resection is recommended with minimally invasive surgery for the diagnosis of NET. Supplementary Information The online version contains supplementary material available at 10.1186/s40792-021-01217-4.
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Affiliation(s)
- Taichi Terai
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Kenji Nakagawa
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kota Nakamura
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Shunsuke Doi
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kohei Morita
- Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Giant Abdominal Lipoma in Adult. Case Rep Surg 2021; 2021:6610533. [PMID: 33763280 PMCID: PMC7946470 DOI: 10.1155/2021/6610533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/15/2021] [Accepted: 02/20/2021] [Indexed: 12/01/2022] Open
Abstract
Lipomas arising from the omentum are extremely rare in adults. Omental lipomas are typically asymptomatic, but very large ones may cause nonspecific abdominal symptoms and discomfort. Rarely they can cause omental torsion and present with an acute abdomen. We report a 41-year-old female patient with a giant lipoma (40 × 26 × 8 cm and 11,520 g) who presented with mild abdominal discomfort. Workup included abdominal ultrasound (USG) and magnetic resonance imaging (MRI). Surgical resection was performed without complication. No recurrence was observed during 4-year follow-up.
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