Dados do Trabalho

Título

Retroperitoneal Liposarcoma: Case Report and Narrative Literature Review

Apresentação do caso

Sarcomas are rare mesenchymal tumors, less than 1% of malignant neoplasms. The retroperitoneal location makes up to 10 to 15% of sarcomas, and, of these, 40 to 50% are classified as liposarcoma. It is reported here the case of EMBL, male, 70 years old, complaining of weight loss of 15kg in 6 months, moderate abdominal pain and abdominal distension in 1 month and decrease of elimination of stools and flatus in 1 week. After submitted to a CT of the total abdomen that revealed a voluminous intraperitoneal expansive formation with 35.0 x 33.0 x 23.0 cm, hypervascularized, with attenuation of fat and soft tissues and well-defined calcifications, with mass effect on pelvic and abdominal structures. Compression on the right proximal ureter is highlighted, revealing post-obstructive nephropathy. Laparotomy with radical tumor resection was performed, with the right testicle being removed and bladder rafia. After biopsy, the tumor was evaluated at 11.5kg and the diagnosis of dedifferentiated liposarcoma was made, without lymphovascular invasion. The patient was not submitted to additional therapy.

Discussão

Liposarcomas are histologically categorized as well differentiated, dedifferentiated, myxoid, pleomorphic and mixed. The well differentiated and dedifferentiated types are the most common on the retroperitoneum, with slow growth and high local recurrence rate.
The well differentiated presents a low metastatic risk, being local control the factor of higher impact in prognosis and mortality. The dedifferentiated can be primary or secondary to a well differentiated, and has a metastasis rate of 15 to 30%.
Due to slow tumoral growth and retroperitoneum compliance, patients may be asymptomatic for long periods, leading to the diagnosis of great tumors, through imaging exams and many times, incidental. Abdominal pain and distension are common; gastric fullness and lower member edema are less recurrent.
The effective treatment is complete surgical resection of the tumoral mass with free surgical margins with a better outcome at the R0 resection.

Comentários Finais

As in the literature, the patient presented abdominal symptoms with diagnosis of the great mass through imaging exams. Besides the greater aggressiveness of this dedifferentiated liposarcoma category – a defining prognosis factor that increases

Palavras Chave

liposarcoma; retroperitoneal neoplasms; abdominal neoplasm