Giant retroperitoneal liposarcoma: а case report

BACKGROUND

Liposarcoma is a neoplasm of mesodermic origin derived from adipose tissue and represents the most frequent histopathological variety of the retroperitoneum. Retroperitoneal liposarcoma may grow to a large size without symptoms. Approximately 20% of the tumours are >10 cm at the time of diagnosis and may reach extremely giant dimensions.

CASE PRESENTATION

We present the case of a 58-year-old woman with a giant retroperitoneal liposarcoma. The patient presented at our clinic with diffuse abdominal pain and enormous abdominal distension. She had swellings and redness of the right leg. CT scan revealed a 50×25 cm sized enhancing soft mass. Ultrasound guided biopsy was negative for the presence of malignant cells. A double "J" ureteral stent was placed in the right ureter. We performed surgery with complete resection of the tumorous mass without multiorgan resection and with macroscopic free margins. A well differentiated, lipoma-like subtype of retroperitoneal liposarcoma, weighing 13.4 kg, was diagnosed in the histopathological report. At 6 months after surgery a new CT scan was done and there was no evidence of recurrence. Currently, after 12 months of follow-up, the patient is asymptomatic and disease free.

CONCLUSION

Surgery is the gold standard for treatment of retroperitoneal liposarcomas, well differentiated retroperitoneal liposarcomas, that have a minimal metastatic potential. It is preferable to place a ureteral stent before surgery for minimizing the risk of intraoperative lesions of ureters. Symptoms in lower extremities, such as swelling, redness and others, that are due to compression in the retroperitoneum by giant tumours, can disappear after their surgical removal.

Pneumatosis cystoides intestinalis related to gastric outlet obstruction: a case report

Pneumatosis remains a rare condition presenting with multiple gas filled cysts at various parts of the GIT. It islmost always a secondary finding in a already active disease. It is very usual for it to be found occasionally at a routine examination. In the following study we present a case of intestinal pneumatosis in a 49-year-old female patient who underwent routine surgery for gastric dilatation as a complication of a chronic peptic ulcer. After exploration of the abdominal cavity, a polycystic tumor formation was found at the terminal ileum. It was further resected and sent for pathohystology analysis according to which it was stated that it was a cystoid intestinal pneumatosis on a terminal ileum. The presented case went in favour of the mechanical theory which states that pyloric gastric outlet obstruction is the most common cause of intestinal pneumatosis.