Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1675
Peer-review started: August 21, 2021
First decision: November 17, 2021
Revised: December 8, 2021
Accepted: January 8, 2022
Article in press: January 8, 2022
Published online: February 16, 2022
Processing time: 173 Days and 11.4 Hours
Retroperitoneal lipomas are extremely rare tumors and tend to be large in size (> 10 cm) when diagnosed, causing various clinical manifestations. Preoperative diagnosis of retroperitoneal lipomas is difficult. There is a lack of relevant information about the management and prognosis of these benign tumors due to limited reports.
A 53-year-old woman who complained about progressive abdominal distention and aggravating satiety was referred to the gynecological outpatient department of Peking Union Medical College Hospital. Computerized tomography (CT) revealed an immense mass with fat density, measuring 28.6 cm× 16.6 cm in size. Adjacent organs, including the intestinal tract and uterus, were squeezed to the right side of the abdomen. An exploratory laparotomy was performed with suspicion of liposarcoma. Intraoperatively, a giant yellowish lobulated mass was found occupying the retroperitoneum and it was removed by tumor debulking. Postoperative histopathological results confirmed the diagnosis of retroperitoneal lipoma.
Retroperitoneal lipoma is a very rare condition and is difficult to differentiate from well-differentiated liposarcoma. Radiographic investigations, especially CT and magnetic resonance imaging, are important for preoperative diagnosis. Surgical resection is the fundamental treatment, which is difficult due to its size and relation to neighboring structures.
Core Tip: Retroperitoneal lipomas are rare benign tumors originating from adipose tissues and they tend to have large sizes. Imaging examinations, especially computerized tomography and magnetic resonance imaging, are fundamental diagnostic tools for these tumors. Surgical resection is the main treatment method. En bloc resection is commonly required. Postoperative histopathology determines the final diagnosis, and immunohistochemical analysis could be useful in the differentiation of liposarcomas. Regular follow-ups are also required for the patients.