Retroperitoneal liposarcoma in a nonagenarian
DOI:
https://doi.org/10.4322/acr.2020.224Keywords:
Sarcoma, Retroperitoneal neoplasms, Colorectal Surgery, Colonic Neoplams, AgedAbstract
Retroperitoneal liposarcomas are rare tumors arising from the soft tissue of the retroperitoneum and are of mesenchymal cell origin. They can reach a large size prior to causing symptoms and generally have a poor prognosis. We present the case of a 93-year-old lady presenting with a large retroperitoneal liposarcoma at the site of a previous colonic anastomosis for the adenocarcinoma treatment. It caused minimal symptoms initially, but surgical resection was undertaken when the tumor was found to be growing significantly in size. However, due to the tumor’s location and its invasion into surrounding structures, the resection was not feasible and subsequently abandoned. A retroperitoneal liposarcoma arising from the site of a previous colonic resection has not been previously described. A review of the diagnosis and current management of these lesions is also given.
Downloads
References
Mack TM. Sarcomas and other malignancies of soft tissue, retroperitoneum, peritoneum, pleura, heart, mediastinum, and spleen. Cancer. 1995;75(1, Suppl 1):211-44. http://dx.doi.org/10.1002/1097-0142(19950101)75:1+<211::AID-CNCR2820751309>3.0.CO;2-X. PMid:8000998.
Porter GA, Baxter NN, Pisters PW. Retroperitoneal sarcoma: a population-based analysis of epidemiology, surgery, and radiotherapy. Cancer. 2006;106(7):1610-6. http://dx.doi.org/10.1002/cncr.21761. PMid:16518798.
Moyon FX, Moyon MA, Turino JF, Yu A, Mafla OL, Molina GA. Massive dedifferentiated retroperitoneal liposarcoma in a young patient. J Surg Case Rep. 2018(10):rjy272. http://dx.doi.org/10.1093/jscr/rjy272.
Molina G, Hull MA, Chen YL, et al. Preoperative radiation therapy combined with radical surgical resection is associated with a lower rate of local recurrence when treating unifocal, primary retroperitoneal liposarcoma. J Surg Oncol. 2016;114(7):814-20. http://dx.doi.org/10.1002/jso.24427. PMid:27634478.
Brennan MF. Management of soft tissue sarcoma. New York: Springer; 2013. 380 p. http://dx.doi.org/10.1007/978-1-4614-5004-7.
Garber JE, Offit K. Hereditary cancer predisposition syndromes. J Clin Oncol. 2005;23(2):276-92. http://dx.doi.org/10.1200/JCO.2005.10.042. PMid:15637391.
Matthyssens LE, Creytens D, Ceelen WP. Retroperitoneal liposarcoma: current insights in diagnosis and treatment. Front Surg. 2015;2:4-4. http://dx.doi.org/10.3389/fsurg.2015.00004. PMid:25713799.
Warren S. Minimal criteria required to prove causation of traumatic or occupational neoplasms. Ann Surg. 1943;117(4):585-95. http://dx.doi.org/10.1097/00000658-194304000-00008. PMid:17858205.
Kulaylat MN, Karakousis CP, Keaney CM, McCorvey D, Bem J, Ambrus JL Sr. Desmoid tumor: a pleomorphic lesion. Eur J Surg Oncol. 1999;25(5):487-97. http://dx.doi.org/10.1053/ejso.1999.0684. PMid:10527597.
Hapgood C, DeLong A. Recurrent Enlarging Mesenteric Desmoid Tumor following Remote Surgical Resection. Case Rep Radiol. 2017;2017:2312617. http://dx.doi.org/10.1155/2017/2312617. PMid:29403670.
Okada N, Nakamura F, Nanno Y, et al. Case of intra-abdominal spindle cell tumor after laparoscopic resection of sigmoid colon cancer. Asian J Endosc Surg. 2016;9(1):68-71. http://dx.doi.org/10.1111/ases.12223. PMid:26781531.
Shih LY, Wei CK, Lin CW, Tseng CE. Postoperative retroperitoneal desmoid tumor mimics recurrent gastrointestinal stromal tumor: a case report. World J Gastroenterol. 2012;18(42):6172-6. http://dx.doi.org/10.3748/wjg.v18.i42.6172. PMid:23155350.
Messiou C, Morosi C. Imaging in retroperitoneal soft tissue sarcom. J Surg Oncol. 2018;117(1):25-32. http://dx.doi.org/10.1002/jso.24891. PMid:29193092.
Rizer M, Singer AD, Edgar M, Jose J, Subhawong TK. The histological variants of liposarcoma: predictive MRI findings with prognostic implications, management, follow-up, and differential diagnosis. Skeletal Radiol. 2016;45(9):1193-204. http://dx.doi.org/10.1007/s00256-016-2409-4. PMid:27209201.
Serpell JW, Pitcher M. Preoperative core biopsy of soft tissue tumors facilitates their surgical management. Aust N Z J Surg. 1998;68(5):345-9. http://dx.doi.org/10.1111/j.1445-2197.1998.tb04769.x. PMid:9631907.
Wilkinson MJ, Martin JL, Khan AA, Hayes AJ, Thomas JM, Strauss DC. Percutaneous core needle biopsy in retroperitoneal sarcomas does not influence local recurrence or overall survival. Ann Surg Oncol. 2015;22(3):853-8. http://dx.doi.org/10.1245/s10434-014-4059-x. PMid:25190132.
Singer S, Antonescu CR, Riedel E, Brennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg. 2003;238(3):358-70, discussion 370-1. http://dx.doi.org/10.1097/01.sla.0000086542.11899.38. PMid:14501502.
Dalal KM, Kattan MW, Antonescu CR, Brennan MF, Singer S. Subtype specific prognostic nomogram for patients with primary liposarcoma of the retroperitoneum, extremity, or trunk. Ann Surg. 2006;244(3):381-91. PMid:16926564.
Pernick N. Stains MDM2. PathologyOutlines.com [cited 2020 May 6]. Available from: http://www.pathologyoutlines.com/topic/stainsmdm2.html
Binh MBN, Sastre-Garau X, Guillou L, et al. MDM2 and CDK4 immunostainings are useful adjuncts in diagnosising well-differentiated and dedifferentiated liposarcoma subtypes: a comparative analysis of 559 soft tissue neoplasms with genetic data. Am J Surg Pathol. 2005;29(10):1340-7. http://dx.doi.org/10.1097/01.pas.0000170343.09562.39. PMid:16160477.
Baldini EH. The conundrum of retroperitoneal liposarcoma – to be more aggressive or less aggressive. Int J Radiat Oncol Biol Phys. 2017;98(2):269-70. http://dx.doi.org/10.1016/j.ijrobp.2017.01.203. PMid:28463143.
Zhang WD, Liu DR, Que RS, et al. Management of retroperitoneal liposarcoma A case report and review of the literature. Oncol Lett. 2015;10(1):405-9. http://dx.doi.org/10.3892/ol.2015.3193. PMid:26171040.
Ito H, Hornick JL, Bertagnolli MM, et al. Leiomyosarcoma of the inferior vena cava: survival after aggressive management. Ann Surg Oncol. 2007;14(12):3534-41. http://dx.doi.org/10.1245/s10434-007-9552-z. PMid:17896156.
Bonalot S, Gronchi A, Le Pechoux C, et al. STRASS (EORTC 62092): a phase III randomized study of preoperative radiotherapy plus surgery versus surgery alone for patients with retroperitoneal sarcoma. J Clin Oncol. 2019;37(15 Suppl);11001-11001. http://dx.doi.org/10.1200/JCO.2019.37.15_suppl.11001.
Dumitra S, Gronchi A. The diagnosis and management of retroperitoneal sarcoma. Oncology. 2018;32(9):464-9. PMid:30248168.
Crago AM, Dickson MA. Liposarcoma: multimodality management and future targeted therapies. Surg Oncol Clin N Am. 2016;25(4):761-73. http://dx.doi.org/10.1016/j.soc.2016.05.007. PMid:27591497.
Crago AM, Singer S. Clinical and molecular approaches to well differentiated and dedifferentiated liposarcoma. Curr Opin Oncol. 2011;23(4):373-8. http://dx.doi.org/10.1097/CCO.0b013e32834796e6. PMid:21552124.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Autopsy and Case Reports
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
Authors of articles published by Autopsy and Case Report retain the copyright of their work without restrictions, licensing it under the Creative Commons Attribution License - CC-BY, which allows articles to be re-used and re-distributed without restriction, as long as the original work is correctly cited.
