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Johari F, Zakaria AD, Ramely R, Hameed Sultan MA, Muhamad Zin MH, Awang Setia S, Hayati F. A rare presentation of retroperitoneal liposarcoma presented with jejunal intussusception: An interesting radiological findings. Radiol Case Rep 2024; 19:3283-3286. [PMID: 38812591 PMCID: PMC11133495 DOI: 10.1016/j.radcr.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/31/2024] Open
Abstract
A jejunal intussusception as a presentation of retroperitoneal liposarcoma (RLPS) is a rare occurrence. The majority of RLPS are presented as an abdominal mass, however, having a jejunal obstruction is an interesting case. The aim is to describe the management of jejunal intussusception secondary to atypical lipomatous tumours with concurrent RLPS. A 61-year-old lady presented with a sudden onset of intestinal obstruction with 1 month of constitutional symptoms and an enlarging right lumbar mass. Computed tomography showed a small bowel intussusception with diffuse peritoneal and retroperitoneal lipomatosis. Emergency exploratory laparotomy, segmental bowel resection, and partial excision of intraperitoneal mesenteric lipoma were performed. A stage En-bloc resection of the RLPS and right nephrectomy was done later. However, she refused for subsequent surgery. A complete resection is the gold standard in managing RLPS. In this report, the management is rendered not to the standard as the patient first presented with intestinal obstruction requiring emergency reduction with a piecemeal resection. A stage surgery was required to determine a promising prognosis, but the patient refused such surgery. A small bowel intussusception in adults is rare but is mostly caused by a tumor or neoplasm. Early recognition of the complexity of the case should be preempted and referred to the tertiary team for further definitive surgery. Patient exhaustion from the subsequent surgery might hamper the only management available for the case.
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Affiliation(s)
- Farehah Johari
- Department of Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Surgery, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Andee Dzulkarnaen Zakaria
- Department of Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Surgery, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Rosnelifaizur Ramely
- Department of Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Surgery, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohamed Arif Hameed Sultan
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Muhamad Hud Muhamad Zin
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Shahrunizam Awang Setia
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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Nguyen HP, Nguyen D, Vu AK, Pham PV. A Case of a Giant Liposarcoma at Binh Dan Hospital. Cureus 2024; 16:e61992. [PMID: 38984007 PMCID: PMC11231960 DOI: 10.7759/cureus.61992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2024] [Indexed: 07/11/2024] Open
Abstract
Retroperitoneal liposarcomas (RLSs) are uncommon mesenchymal tumors that might present a diagnostic challenge due to their rarity and anatomical location. Despite grossly complete resections, they are commonly linked to a high recurrence rate, necessitating long-term or indefinite follow-up. This report discusses a 59-year-old male patient referred to the Gastrointestinal Department due to chronic abdominal distention, right-sided back pain, and a sizable abdominal mass. The diagnosis was an RLS, and the patient underwent en bloc resection of the mass.
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Affiliation(s)
- Huu P Nguyen
- Department of Gastrointestinal Surgery, Binh Dan Hospital, Ho Chi Minh City, VNM
| | - Duy Nguyen
- Department of General Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VNM
| | - An K Vu
- Department of Gastrointestinal Surgery, Binh Dan Hospital, Ho Chi Minh City, VNM
| | - Phu V Pham
- Department of Gastrointestinal Surgery, Binh Dan Hospital, Ho Chi Minh City, VNM
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Wang X, Song X, Song Q, Wang J, Chen J. Recurrent retroperitoneal liposarcoma with multiple surgeries: a case report. Front Oncol 2024; 14:1363055. [PMID: 38764575 PMCID: PMC11102049 DOI: 10.3389/fonc.2024.1363055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Retroperitoneal liposarcoma (RPLPS) is a rare malignant tumor that is typically treated with surgical resection. However, RPLPS often has a high rate of local recurrence, making it crucial to explore new treatment options. In this report, we present the case of a middle-aged woman who experienced seven recurrences and underwent seven surgeries following the initial resection. Currently, the patient's condition remains stable after the eighth surgery. Although there have been numerous reports of RPLPS cases both domestically and internationally, instances of repeated recurrence like this are exceptionally rare. Therefore, we have gathered the patient's case data and conducted a retrospective analysis, incorporating relevant literature, to enhance the understanding of this disease among clinical practitioners.
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Affiliation(s)
- Xiao Wang
- Department of Gastrointestinal Surgery, Baotou Central Hospital, Baotou, Inner Mongolia, China
- Baotou Clinical Medical College, Inner Mongolia Medical University, Baotou, Inner Mongolia, China
| | - Xiaobiao Song
- Department of Gastrointestinal Surgery, Baotou Central Hospital, Baotou, Inner Mongolia, China
| | - Qiang Song
- Department of Gastrointestinal Surgery, Baotou Central Hospital, Baotou, Inner Mongolia, China
| | - Jijun Wang
- Department of Gastrointestinal Surgery, Baotou Central Hospital, Baotou, Inner Mongolia, China
| | - Junsheng Chen
- Department of Gastrointestinal Surgery, Baotou Central Hospital, Baotou, Inner Mongolia, China
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Usuga D, Atri E, Alloush F, Poppiti R, Bhandari A. A Large Retroperitoneal Liposarcoma Mimicking an Angiomyolipoma on Pre-operative Imaging: A Case Report. Cureus 2023; 15:e44325. [PMID: 37779766 PMCID: PMC10538462 DOI: 10.7759/cureus.44325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Retroperitoneal masses present a diagnostic challenge due to their elusive origin and varied clinical manifestations. Among these masses, retroperitoneal liposarcomas, rare tumors of mesenchymal origin, often grow asymptomatically until compressing surrounding structures, necessitating accurate and early diagnosis. Renal angiomyolipomas (AMLs) have also been reported to mimic retroperitoneal liposarcomas on radiographic imaging, further complicating diagnostic processes. The presented case report describes a rare instance of a large well-differentiated liposarcoma that mimicked a renal angiomyolipoma on imaging in a 58-year-old male patient. The patient initially presented with worsening abdominal distension, early satiety, and left-sided flank pain for the past year. Radiographic imaging revealed a large mixed echogenic lesion measuring 22 x 13 cm in the left kidney with diffuse fat contribution, suspected to be a giant renal angiomyolipoma. The patient underwent selective arterial embolization by interventional radiology. Follow-up imaging eight months later showed an increase in the size of the mass, raising suspicion of a liposarcoma. Surgical resection of the mass and a radical left nephrectomy were performed, with final pathology confirming the diagnosis of a well-differentiated liposarcoma. This case highlights the importance of accurate diagnosis and the potential for liposarcomas to mimic other masses on imaging, despite their rarity.
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Affiliation(s)
- Daniela Usuga
- Medical Student, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Elias Atri
- Urology, Mount Sinai Medical Center, Miami Beach, USA
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Liao T, Du W, Li X, He S, Guan G, Zhu H, Wu J. Recurrent metastatic retroperitoneal dedifferentiated liposarcoma: a case report and literature review. BMC Urol 2023; 23:63. [PMID: 37095466 PMCID: PMC10123999 DOI: 10.1186/s12894-023-01252-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Retroperitoneal liposarcoma (RPLPS), a rare tumor, is often treated using surgical procedures as the first choice for treatment. However, there is no consensus on the scope of surgical resection. In addition, the treatment outcomes of conventional radiotherapy and chemotherapy have not been satisfactory, particularly for specific types of LPS, such as dedifferentiated LPS. In this case study, we present a brief review of other cases of RPLPS, highlighting the selection of surgical scope for RPLPS and related adjuvant treatment for advanced RPLPS. CASE PRESENTATION A case study is reported regarding an extremely rare recurrent and metastatic retroperitoneal dedifferentiated LPS. The primary RPLPS tumor, with a diameter of 20 cm and a weight of 2.5 kg, occupied the whole left abdomen and adhered to the left kidney. A surgical tumor resection combined with a left nephrectomy is performed. During the 6th -month postoperative follow-up examination, we observed the local recurrence of the tumor in the operation area, in addition to multiple metastatic tumors in both lungs. Further, the prescribed 3-month targeted treatment with anlotinib significantly reduced the size of the metastatic pulmonary tumors. However, the recurrent retroperitoneal tumors showed no significant change in size. Eventually, we observed no substantial evidence of tumor progression, with the patient's condition under control. CONCLUSION The case demonstrated that the postoperative recurrence of widespread RPLPS required R0 resection to cure the disease, considering targeted therapy for advanced RPLPS control.
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Affiliation(s)
- Tuming Liao
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China
| | - Wei Du
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China
| | - Xiongcai Li
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China.
| | - Shen He
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China
| | - Gangqiang Guan
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China
| | - Herong Zhu
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China
| | - Jiaqiao Wu
- Department of Urology Surgery, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Nanhai District Hospital of Traditional Chinese Medicine of Foshan City), No. 16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, Guangdong, People's Republic of China
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Kinoshita H, Hashiba E, Uchida S, Hirota K. Successful management of a patient with preoperative respiratory failure due to a solid giant retroperitoneal tumor: a case report. JA Clin Rep 2022; 8:85. [PMID: 36244982 PMCID: PMC9573809 DOI: 10.1186/s40981-022-00575-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We report the successful preoperative management of respiratory failure in a patient with a solid giant retroperitoneal tumor with a hemodynamic monitoring system and nasal high-flow therapy (NHFT). CASE PRESENTATION Twenty days before his scheduled resection of a giant retroperitoneal liposarcoma, a 64-year-old man presented with dyspnea. After admission to our intensive care unit, he received NHFT and hemodynamic therapy using a LiDCOrapid V3™ monitor (Masimo Japan, Tokyo). NHFT and intense diuresis improved his respiratory condition. The tumor resection was performed on the 5th day. He was discharged to the general ward with an oxygen nasal cannula on the second postoperative day. Although preoperative transthoracic echography showed mild aortic regurgitation and moderate mitral regurgitation, the degree of regurgitation had become trivial about 1-month post-surgery. CONCLUSIONS A cause of preoperative respiratory failure associated with a giant retroperitoneal tumor might be not only diaphragmatic compression but also heart failure and excess fluid volume.
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Affiliation(s)
- Hirotaka Kinoshita
- grid.257016.70000 0001 0673 6172Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562 Japan
| | - Eiji Hashiba
- grid.470096.cDivision of Intensive Care, Hirosaki University Hospital, 53 Hon-cho, Hirosaki, 036-8563 Japan
| | - Satoshi Uchida
- grid.257016.70000 0001 0673 6172Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562 Japan
| | - Kazuyoshi Hirota
- grid.257016.70000 0001 0673 6172Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562 Japan
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