Nadir bir olgu: Retroperitoneal liposarkom

Abstract

Retroperitoneal liposarkom (RPLS), retroperitonda ortaya çıkan yumuşak doku sarkomları arasında en yaygın olanıdır. Bu tümörler retroperitonda semptom vermeme­si sebebiyle tanı anında büyük boyutlara eri­şirler. Primer RPLS’nin definitif tedavisi tü­mörün komplet cerrahi rezeksiyonudur fakat kritik anatomik organlara yakınlığı sebebiyle tümörün komplet cerrahi rezeksiyonu zor­dur. Aynı zamanda yüksek rekürrens oranı tedaviyi zorlaştıran önemli bir faktördür. Biz bu olgu sunumunda 20×18×19 cm çapında RPLS vakasını sunuyoruz. Karında şişlik şi­kayetiyle başvuran 49 yaşında erkek hastada RPLS tespit edildi. Dalak, sol böbrek ve sol sürrenal gland ile birlikte tümörün komplet cerrahi rezeksiyonu gerçekleştirilmesine rağ­men rekürrens gelişti. Biz, rekürren tümöre de komplet cerahi rezeksiyon uyguladık. Has­tanın 1 yıllık takibinde rekürrens gelişmedi.

Keywords

• liposarkom
• retroperiton
• RPLS

A rare case: Retroperitoneal liposarcoma

Abstract

Retroperitoneal liposarcoma (RPLS) is the most common of the soft tissue sarcomas that arise in the retroperitoneum. These tumors reach a large size by time of diagnosis due to absence of symptoms in retroperitoneum. The definitive treatment of primary RPLS is com- plete surgical resection of the tumor but due to its proximity to critical anatomical organs, complete surgical resection of the tumor is difficult. At the same time, the high recurrence rate of RPLS is an important factor that complicates treatment. In this case report, we present RPLS measuring 20×18×19 cm in diameter. RPLS was detected in a 49-year-old male patient who complained of abdominal fullness. Recurrence developed despite complete surgical resection of tumor with spleen, left kidney and left adrenal gland. We also per- formed complete resection of recurrent tumor. Recurrence did not develop on follow-up of the patient for 1 year.

Keywords

• Liposarcoma
• retroperitoneum

References

1. 1. Zeng X, Liu W, Wu X, et al. Clinicopathological characte- ristics and experience in the treatment of giant retroperito- neal liposarcoma: A case report and review of the literature. Cancer Biol Ther 2017;18:660-665.
2. 2. Vijay A, Ram L. Retroperitoneal liposarcoma: a comprehen- sive review. Am J Clin Oncol 2015;38:213-9.
3. 3. Chouairy CJ, Abdul-Karim FW, MacLennan GT. Retroperi- toneal liposarcoma. J Urol 2007;177:1145.
4. 4. Sharma M, Mannan R, Bhasin TS, et al. Giant inflammatory variant of well differentiated liposarcoma: a case report of a rare entity. J Clin Diagn Res 2013;7:1720-1721.
5. 5. Makni A, Triki A, Fetirich F, et al. Giant retroperitoneal li- posarcoma. Report of 5 cases. Ann Ital Chir 2012;83:161- 166.
6. 6. Tateishi U, Hasegawa T, Beppu Y, et al. Primary dedifferen- tiated liposarcoma of the retroperitoneum. Prognostic sig- nificance of computed tomography and magnetic resonance imaging features. J Comput Assist Tomogr 2003;27:799-804.
7. 7. Kim T, Murakami T, Oi H, et al. CT and MR imaging of ab- dominal liposarcoma. AJR Am J Roentgenol 1996;166:829- 833.
8. 8. Shibuya T, Mori A, Fushimi Net al. Pelvic retroperitoneal liposarcoma diagnosed by preoperative imaging studies. In- tern Med 2007;46:1263-1264.

9. 9. Song T, Shen J, Liang BL, et al. Retroperitoneal liposarcoma: MR characteristics and pathological correlative analysis. Abdom Imaging 2007;32:668-674.
10. 10. Linehan DC, Lewis JJ, Leung D, et al. Influence of biologic factors and anatomic site in completely resected liposarco- ma. J Clin Oncol 2000;18:1637-1643.
11. 11. Gronchi A, Strauss DC, Miceli R, et al. Variability in Patterns of Recurrence After Resection of Primary Retroperi- toneal Sarcoma (RPS): A Report on 1007 Patients From the Multi-institutional Collaborative RPS Working Group. Ann Surg 2016;263:1002-1009.
12. 12. Bagaria SP, Gabriel E, Mann GN. Multiply recurrent retro- peritoneal liposarcoma. J Surg Oncol 2018;117:62-68.
13. 13. Park JO, Qin LX, Prete FP, et al. Predicting outcome by growth rate of locally recurrent retroperitoneal liposarcoma: the one centimeter per month rule. Ann Surg 2009;250:977- 982.
14. 14. Hamilton TD, Cannell AJ, Kim M, et al. Results of Resecti- on for Recurrent or Residual Retroperitoneal Sarcoma After Failed Primary Treatment. Ann Surg Oncol 2017;24:211- 218.
15. 15. Gronchi A, Lo Vullo S, Fiore M, et al. Aggressive surgical policies in a retrospectively reviewed single-institution case series of retroperitoneal soft tissue sarcoma patients. J Clin Oncol 2009;27:24-30.
16. 16. Gronchi A, Miceli R, Colombo C, et al. Frontline extended surgery is associated with improved survival in retroperito- neal low- to intermediate-grade soft tissue sarcomas. Ann Oncol 2012;23:1067-1073.
17. 17. Bonvalot S, Rivoire M, Castaing M, et al. Primary retrope- ritoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 2009;27:31-37.
18. 18. Lahat G, Anaya DA, Wang X, et al. Resectable well- differentiated versus dedifferentiated liposarcomas: two dif- ferent diseases possibly requiring different treatment appro- aches. Ann Surg Oncol 2008;15:1585-1593.
19. 19. Crago AM. Extended surgical resection and histology in retroperitoneal sarcoma. Ann Surg Oncol 2015;22:1401- 1403.
20. 20. Raut CP, Swallow CJ. Are radical compartmental resecti- ons for retroperitoneal sarcomas justified? Ann Surg Oncol 2010;17:1481-1484.
21. 21. Dalal KM, Kattan MW, Antonescu CR, et al. Subtype speci- fic prognostic nomogram for patients with primary liposar- coma of the retroperitoneum, extremity, or trunk. Ann Surg 2006;244:381-391.
22. 22. Singer S, Antonescu CR, Riedel E, et al. Histologic subt- ype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg 2003;238:358-370; discussion 370-371.