Cheng LL, Tang B, Liu H, Zhu F, Chen YF, Zhang W. Thoughts and challenges of giant retroperitoneal liposarcoma: A case report. World J Clin Cases 2025; 13(26): 108308 [DOI: 10.12998/wjcc.v13.i26.108308]
Corresponding Author of This Article
Wei Zhang, Chief Physician, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan 43000, Hubei Province, China. weizhangtjh@hust.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Li-Li Cheng, Biao Tang, Hui Liu, Fan Zhu, Yi-Fa Chen, The First Department of General Surgery, Ezhou Central Hospital, Ezhou 436000, Hubei Province, China
Wei Zhang, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 43000, Hubei Province, China
Author contributions: Cheng LL was responsible for the study design and manuscript writing; Biao T acquired medical images; Liu H and Zhu F assisted in the operation and clinical data collection; Zhang W performed the operation; Chen YF participated in the study design and manuscript revision; all the authors read and agreed to the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflicts 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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Zhang, Chief Physician, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan 43000, Hubei Province, China. weizhangtjh@hust.edu.cn
Received: April 22, 2025 Revised: May 8, 2025 Accepted: May 28, 2025 Published online: September 16, 2025 Processing time: 92 Days and 17.3 Hours
Abstract
BACKGROUND
Retroperitoneal liposarcoma (RPLS) is a rare malignant tumor initiated in adipocytes. It is discovered only when the tumor is large because of its deep anatomical location and insidious onset. Giant RPLS with a diameter exceeding 30 cm is extremely rare. Its diagnosis and treatment present extremely great challenges.
CASE SUMMARY
The patient, a 62-year-old woman, presented to the hospital complaining of abdominal distension for more than six months. Imaging examination revealed a large retroperitoneal mass. Finally, the patient was diagnosed with giant RPLS. The tumor occupied the entire abdominal cavity, severely compressed the abdominal organs, and adhered tightly to the bilateral ureters. After careful preoperative preparation (including three-dimensional visualization and bilateral ureteral stent implantation), we performed resection of the large retroperitoneal mass. The tumor was completely removed and consisted of multiple masses, with a total weight of 17 kg and the largest mass size of 35 cm × 28 cm × 14 cm. Postoperative pathological results revealed that the mass was a well-differentiated liposarcoma. The patient recovered well after surgery, and there was no sign of recurrence after 2 months of follow-up.
CONCLUSION
Surgical resection is the only radical treatment for giant RPLS. Preoperative preparation is essential, and three-dimensional visualization reconstruction is helpful for the formulation of surgical plans. Postoperative radiotherapy and neoadjuvant therapy can be reasonably selected, but whether they can reduce the recurrence rate is still controversial.
Core Tip: Retroperitoneal liposarcoma (RPLS) is a rare malignant tumor. When its diameter exceeds 30 cm or its weight is no less than 20 kg, it is classified as giant RPLS, which significantly increases the complexity of surgical intervention. Giant RPLS may necessitate concomitant resection of adjacent organs and cannot be completely resected, leading to a high recurrence rate and suboptimal treatment outcomes.
