Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2022; 10(19): 6636-6646
Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6636
Giant retroperitoneal liposarcoma treated with radical conservative surgery: A case report and review of literature
Eva Lieto, Francesca Cardella, Silvia Erario, Giovanni Del Sorbo, Alfonso Reginelli, Gennaro Galizia, Fabrizio Urraro, Iacopo Panarese, Annamaria Auricchio
Eva Lieto, Francesca Cardella, Silvia Erario, Giovanni Del Sorbo, Gennaro Galizia, Annamaria Auricchio, Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
Alfonso Reginelli, Fabrizio Urraro, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples 80138, Campania, Italy
Iacopo Panarese, Depatment of Pathology Unit-Menthal Health, University of Campania "L. Vanvitelli", Naples 80132, Campania, Italy
Author contributions: Lieto E and Cardella F contributed to conceptualization; Erario S, and Del Sorbo G contributed to organization of data; Reginelli A and Urraro F provided radiological imaging; Auricchio A and Cardella F contributed to writing the first draft; Panarese I contributed to provision of the histological slides; Lieto E and Galizia G contributed to the revision; All authors read and approved the submitted manuscript.
Informed consent statement: The patient gave his informed consent, according to the Vanvitelli University rules, for the article publication, including the pictures, unless they prevent any possible identification.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Eva Lieto, MD, PhD, Assistant Professor, Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Piazza Miraglia, 1 Pad. 3 East, Naples 80128, Campania, Italy.
Received: January 5, 2022
Peer-review started: January 5, 2022
First decision: March 7, 2022
Revised: March 19, 2022
Accepted: May 8, 2022
Article in press: May 8, 2022
Published online: July 6, 2022

Retroperitoneal liposarcoma (RLPS) is a rare malignant tumor of the connective tissue and usually grows to a large size, undetected. Diagnosis is currently based on collective findings from clinical examinations and computed tomography (CT) and magnetic resonance imaging, the latter of which show a fat density mass and possible surrounding organ involvement. Surgical resection is the main therapeutic strategy. The efficacy and safety of further therapeutic choices, such as chemotherapy and radiotherapy, are still controversial.


A 61-year-old man presented with complaint of a large left inguinal mass that had appeared suddenly, after a slight exertion. Ultrasonography revealed an omental inguinal hernia. During further clinical examination, an enormous palpable abdominal mass, continuing from the left inguinal location, was observed. CT revealed a giant RLPS, with remarkable mass effect and wide visceral dislocation. After multidisciplinary consultation, surgical intervention was performed. Subsequent neoadjuvant chemotherapy and radiotherapy were precluded by the mass’ large size and retroperitoneal localization, features typically associated with non-response to these types of treatment. Instead, the patient underwent conservative treatment via radical surgical excision. After 1 year, his clinical condition remained good, with no radiological signs of recurrence.


Conservative treatment via surgery resulted in a successful outcome for a large RLPS.

Keywords: Retroperitoneal liposarcoma, Giant sarcoma, Sarcoma surgical treatment, Sarcoma diagnosis, Differentiated liposarcoma, Retroperitoneal sarcoma surgical outcome, Case report

Core Tip: Giant retroperitoneal liposarcoma (RLPS) is a rare condition. The tumor arises from retroperitoneal fatty tissue in the space between the peritoneum and posterior abdominal wall. Owing to the absence of any functional impairment for a long time, RLPS can reach large dimensions before the onset of symptoms. We report the case of a man who received a misdiagnosis of inguinal hernia and was scheduled for intervention. After a careful clinic approach and further radiological examinations, the tumor was removed by radical surgery without any damage to surrounding organs. At the 1-year follow-up no recurrence was present.