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Mori K, Igarashi T, Noguchi A, Ito M, Nagaoka Y, Takeshita C, Takeda N, Watanabe T, Yoshioka I, Hirabayashi K, Fujii T. Giant retroperitoneal myolipoma mimicking liposarcoma: report of a resected case and review of the literature. Int Cancer Conf J 2024; 13:144-152. [PMID: 38524654 PMCID: PMC10957821 DOI: 10.1007/s13691-024-00655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/01/2024] [Indexed: 03/26/2024] Open
Abstract
Myolipomas are rare tumors that are often difficult to differentiate from liposarcoma. Herein, we report a case of resected giant myolipoma preoperatively diagnosed as liposarcoma. A 63-year-old woman was suspected of having a large retroperitoneal liposarcoma on October 202X. The patient was referred to our department for tumor resection and a histological diagnosis. After consultation with the urology, obstetric and gynecology, and vascular surgery departments, tumor resection was planned, including the potential resection of other organs. Intraoperative findings revealed a large, elastic, soft tumor with a smooth surface and a capsule occupying the entire abdominal cavity. The tumor was adherent to the stomach, left colon, and uterine adnexa, and no invasion was observed. The tumor was completely resected, and organ resection was not necessary. The tumor was 40 cm in diameter and 4.0 kg in weight. Pathological examination and immunostaining confirmed a diagnosis of myolipoma. The patient's postoperative course was uneventful, and she was discharged on postoperative day 10 with no complications. Twelve months after surgery, the patient was doing well. To the best of our knowledge, we report a complete resection of the largest retroperitoneal myolipoma reported to date. Physicians should consider surgery, even for suspected large sarcomas that may be difficult to resect completely.
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Affiliation(s)
- Kosuke Mori
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Takamichi Igarashi
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Akira Noguchi
- Department of Diagnostic Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Toyama 930-0194 Japan
| | - Miki Ito
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Yasuhiro Nagaoka
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Chitaru Takeshita
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Naoya Takeda
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Toru Watanabe
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Isaku Yoshioka
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Kenichi Hirabayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Toyama 930-0194 Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
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Hu X, Han B, Yang Q, Li Q, Xiao D, Xu X. Recurrence of locally invasive retroperitoneal dedifferentiated liposarcoma shortly after surgery: A case report and literature review. Medicine (Baltimore) 2024; 103:e37604. [PMID: 38552050 PMCID: PMC10977592 DOI: 10.1097/md.0000000000037604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/23/2024] [Indexed: 04/02/2024] Open
Abstract
RATIONALE Retroperitoneal dedifferentiated liposarcoma (RPDDL) is an uncommon malignancy, which often remains undetected for many years due to having adequate space in the retroperitoneal cavity and lacking clinical manifestations in the early stage of the disease. Surgical procedure is usually used as the first choice for treatment. However, it is prone to local recurrence after the operation, resulting in an unfavorable prognosis. Our aim is to draw useful lessons from the new case and provide some experience for management of the disease. PATIENT CONCERNS We describe a 55-year-old male patient who was admitted for a 3-week history of persistent dull ache of the left waist. A large mass of the left upper abdomen was palpated in physical examination. Moreover, the imaging examination revealed that the diameter of the mass was about 21 cm, and some adjacent vital organs were invaded, which brought great challenges to complete surgical resection. DIAGNOSIS The postoperative pathological results confirmed that the mass was RPDDL with invasion of the surrounding vital structures including pancreas, spleen, left adrenal gland, left kidney, and vasculature with tumor emboli. INTERVENTIONS Surgical resection of the mass was performed by our multidisciplinary team. The patient received chemotherapy 1 month after surgery. OUTCOMES The effect of chemotherapy seemed to be unsatisfactory. Local multifocal recurrence of the tumor was considered about 2 months after surgery. Finally, he gave up any treatments and died of the disease. LESSONS Regular physical examination and ultrasound screening may detect the disease as early as possible, especially for high-risk group aged 60 to 70, which should be popularized. Incomplete resection, vascular invasion, and interruption of postoperative treatment may lead to an unfavorable prognosis. Therefore, we think that patients with the disease may benefit from complete surgical resection and uninterrupted adjuvant therapy.
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Affiliation(s)
- Xuelian Hu
- Department of Nephrology, First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Bo Han
- Department of General Surgery, 63650 Military Hospital, Xinjiang, China
| | - Qin Yang
- Department of Nephrology, First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Qixuan Li
- Department of Nephrology, First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongkai Xiao
- Department of Medical Service, First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaosong Xu
- Department of Nephrology, First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
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Akaihata M, Takahashi I, Kakuda Y, Kawata T, Mukaigawa T, Onitsuka T, Murayama S, Ishida Y. Head pleomorphic sarcoma showing murine double minute 2 amplification without a well-differentiated liposarcoma component in a pediatric patient. Cancer Rep (Hoboken) 2023; 6:e1774. [PMID: 36572546 PMCID: PMC9939988 DOI: 10.1002/cnr2.1774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/28/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Murine double minute 2 (MDM2) is an oncogene that inhibits p53, leading to decreased apoptosis. Sarcomas showing MDM2 amplification are rare among pediatric patients. CASE A 14-year-old boy presented with pleomorphic sarcoma of the head showing MDM2 amplification without a well-differentiated liposarcoma component. Although chemotherapy was initially performed to reduce the tumor size before surgery, the tumor did not shrink. The patient underwent complete surgical resection. Microscopic examination revealed a positive surgical margin; thus, postoperative proton-beam radiotherapy was performed. 3 years after the therapy, no sign of recurrence was observed. CONCLUSION Macroscopic surgical resection combined with adjuvant postoperative radiotherapy was effective against MDM2-amplified pleomorphic sarcoma refractory to neoadjuvant chemotherapy in a pediatric patient.
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Affiliation(s)
| | | | - Yuko Kakuda
- Division of PathologyShizuoka Cancer CenterShizuokaJapan
| | - Takuya Kawata
- Division of PathologyShizuoka Cancer CenterShizuokaJapan
| | - Takashi Mukaigawa
- Division of Head and Neck SurgeryShizuoka Cancer CenterShizuokaJapan
| | - Testuro Onitsuka
- Division of Head and Neck SurgeryShizuoka Cancer CenterShizuokaJapan
- Division of Head and Neck SurgeryMishima Central HospitalShizuokaJapan
| | | | - Yuji Ishida
- Division of PediatricsShizuoka Cancer CenterShizuokaJapan
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Xia H, Fang F, Yuan H, Tu Y. Survival of a patient with multiple-recurrent giant retroperitoneal dedifferentiated liposarcoma for 15 years: A case report. Front Surg 2022; 9:916802. [DOI: 10.3389/fsurg.2022.916802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
BackgroundRetroperitoneal liposarcoma (RPLS) is a variety of soft tissue sarcoma that originates from mesenchymal cells. A tumor measuring greater than 30 cm is called a “giant liposarcoma.” A part of the neoplasm tends to grow in size, recur locally, or metastasize distantly. In those with such a condition, long-term survival is uncommon. Therefore, it is necessary to present a uniform and optimized program to improve the prognosis.MethodsBy successfully treating a multiple-recurrent giant retroperitoneal dedifferentiated liposarcoma (RP DDLPS) in July 2010, we hope to devise more comprehensive strategies to improve diagnosis, therapy, and outcome.ResultsIn July 2010, we thoroughly resected a giant multifocal RPLS with a concomitant part of the gastric wall. The histopathological examination revealed a high-grade (grade III) dedifferentiated liposarcoma. The patient was discharged uneventfully on the 15th postoperative day. She relapsed after 16 months and needed another complete excision. After 9 months, she died after the fourth recidive. The patient had experienced four recurrences and underwent operations with 15 years of follow-up.ConclusionsThe above demonstrates that we were able to successfully treat the multirecurrent giant RPLS, despite the patient’s poor medical condition, with meticulous management. Moreover, this indicates that long-term survival could be achieved for high-grade RP DDLPS.
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Tani A, Tarumi Y, Kakibuchi A, Aoyama K, Kokabu T, Kataoka H, Yoriki K, Nagamine M, Mori T. Giant retroperitoneal dedifferentiated liposarcoma mimicking ovarian cancer: A case report. Gynecol Oncol Rep 2022; 44:101088. [PMID: 36299399 PMCID: PMC9589010 DOI: 10.1016/j.gore.2022.101088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Clinical features of the dedifferentiated subtype of LPS that has a diameter of >30 cm remains unknown. Surgical resection entails a high risk due to the size and anatomical location and difficulty in preoperative diagnosis. CT is the most useful imaging method for evaluating tumor location, size, origin, and relationship to adjacent organs. Retroperitoneal LPS should be considered in the case of a giant intra-abdominal tumor with a fatty component. Surgical resection is the mainstay of treatment for retroperitoneal LPS.
Retroperitoneal liposarcoma is a rare tumor, and its dedifferentiated subtype and a larger diameter are associated with a poor prognosis. However, there are few reports of retroperitoneal liposarcomas, both with a dedifferentiated subtype and a diameter of >30 cm. We report a case of a giant retroperitoneal liposarcoma with a dedifferentiated subtype. A 78-year-old woman presented to our hospital with abdominal distension and loss of appetite. Computed tomography and magnetic resonance imaging findings revealed a 35-cm-diameter solid tumor in the peritoneal cavity. CA125 (64.8 U/mL) and HE4 (229.0 pmol/L) were elevated preoperatively raising suspicion for ovarian malignancy. However, intraoperative findings revealed that the tumor originated in the retroperitoneal cavity. Reductive surgery for the tumor and partial resection of the sigmoid colon and left ureter were performed, and pathological examination confirmed a retroperitoneal dedifferentiated liposarcoma. Although her symptoms improved postoperatively, she died 11 months after surgery due to disease progression.
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Affiliation(s)
- Akihiro Tani
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yosuke Tarumi
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan,Corresponding author.
| | - Akiyo Kakibuchi
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kohei Aoyama
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tetsuya Kokabu
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hisashi Kataoka
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kaori Yoriki
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Michiko Nagamine
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Taisuke Mori
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Lieto E, Cardella F, Erario S, Del Sorbo G, Reginelli A, Galizia G, Urraro F, Panarese I, Auricchio A. Giant retroperitoneal liposarcoma treated with radical conservative surgery: A case report and review of literature. World J Clin Cases 2022; 10:6636-6646. [PMID: 35979304 PMCID: PMC9294896 DOI: 10.12998/wjcc.v10.i19.6636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/19/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND 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.
CASE SUMMARY 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.
CONCLUSION Conservative treatment via surgery resulted in a successful outcome for a large RLPS.
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Affiliation(s)
- Eva Lieto
- Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
| | - Francesca Cardella
- Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
| | - Silvia Erario
- Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
| | - Giovanni Del Sorbo
- Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples 80138, Campania, Italy
| | - Gennaro Galizia
- Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
| | - 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
| | - Annamaria Auricchio
- Department of Traslational Medical Sciences, University of Campania "L. Vanvitelli", Naples 80128, Campania, Italy
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Coco D, Leanza S, Reina GA. Giant Retroperitoneal Mass: Case Report in a Primary Hospital and Review of the Literature. MAEDICA 2022; 17:226-229. [PMID: 35733757 PMCID: PMC9168591 DOI: 10.26574/maedica.2022.17.1.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Retroperitoneal liposarcoma (RPLS) is a rare form of cancer that mostly affects adults. Symptoms may be undetected unless the tumor begins to grow. Diagnosis is made when the tumor is large and puts vital organs such as the pancreas, liver, kidneys at risk. Symptoms of a liposarcoma depend on tumor location. Liposarcoma in the arms, legs, particularly thighs may be painful, swollen, with patients citing weakness in the affected area; 15% of soft tissue sarcomas are retroperitoneal, with two of the most common types being the well-differentiated liposarcoma (WDLPS) and high-grade dedifferentiated liposarcoma (DDLPS). The tumor can weigh between 15 kg and 20 kg, with 20 to 25 cm in diameter (4). Surgery is the main form of treatment provided along with adjuvant therapies. We present the case of a 60-year-old woman who was referred to the Emergency Department with acute onset of abdominal distension, nausea, vomiting, right back pain, lipothymia and a giant abdominal mass.
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Affiliation(s)
- Danilo Coco
- Department of General Surgery, S. Salvatore Hospital, Paterno', S. M. Addolorata Hospital, Biancavilla, Italy
| | - Silvana Leanza
- Department of General Surgery, Carlo Urbani Hospital, Jesi, Ancona, Italy
| | - Giuseppe Angelo Reina
- Department of General Surgery, S. Salvatore Hospital, Paterno', S. M. Addolorata Hospital, Biancavilla, Italy
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Nakahashi K, Yokoyama Y, Fukaya M, Igami T, Mizuno T, Yamaguchi J, Onoe S, Watanabe N, Ebata T. A long-term survivor of advanced retroperitoneal dedifferentiated liposarcoma: a successful multimodal approach with extended resection and chemotherapy. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:200-207. [PMID: 35392006 PMCID: PMC8971026 DOI: 10.18999/nagjms.84.1.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
Surgical resection is the mainstay of treatment for retroperitoneal liposarcoma (RPLS). Herein, we describe a case of dedifferentiated RPLS successfully treated with an extended surgical approach with adjuvant chemotherapy. A 61-year-old male was referred to our hospital with a chief complaint of chest tightness. Abdominal computed tomography revealed a large retroperitoneal tumor, 11 cm in diameter, extensively invading the surrounding organs: the celiac axis, the splenic artery, the pancreatic body and tail, the lesser curvature of the stomach and the left adrenal gland. Endoscopic ultrasound-guided fine-needle aspiration biopsy confirmed dedifferentiated liposarcoma, suggesting aggressive tumor biology. We performed total gastrectomy combined with distal pancreatectomy with celiac axis and left adrenal gland resection with a curative intent. The postoperative course was almost uneventful. As the pathological findings indicated a positive margin with a well-differentiated liposarcoma component, we added adjuvant chemotherapy with four cycles of doxorubicin and ifosfamide (AI). Five years after primary surgery, regular follow-up CT demonstrated a pulmonary hilar lymph node enlargement and a tumor at paraesophageal locations. After downsizing chemotherapy with eribulin followed by pazopanib, he underwent partial esophagectomy with dissection of the paraesophageal tumor. The pathological findings indicated recurrence of dedifferentiated liposarcoma with a tumor-free surgical margin. He is currently alive without any evidence of recurrence almost 7 years after the first surgery and 15 months after the second surgery. The long-term survival gained in this patient indicates that extended resections and adjuvant chemotherapy could prolong survival in patients even with RPLS with dedifferentiated tumor histology.
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Affiliation(s)
- Koichi Nakahashi
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukihiro Yokoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Division of Perioperative Medicine, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japa
| | - Masahide Fukaya
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tsuyoshi Igami
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Mizuno
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Junpei Yamaguchi
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shunsuke Onoe
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Watanabe
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Division of Perioperative Medicine, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japa
| | - Tomoki Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Li WX, Tong HX, Lv CT, Yang H, Zhao G, Lu WQ, Zhang Y. Management of retroperitoneal sarcoma involving the iliac artery: Single-center surgical experience. World J Clin Cases 2022; 10:811-819. [PMID: 35127897 PMCID: PMC8790436 DOI: 10.12998/wjcc.v10.i3.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/15/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Management of retroperitoneal sarcoma (RPS) involving the iliac artery is challenging and requires the concerted efforts of multidisciplinary team (MDT) members during surgical treatment.
AIM To summarize the clinicopathologic features of RPS involving the iliac artery and our retroperitoneal soft tissue tumor MDT surgical experience.
METHODS In this retrospective study, 15 patients with RPS involving the iliac artery who underwent surgery at our retroperitoneal soft tissue tumor center from July 2004 to June 2020 were analyzed. Statistical analyses were performed by Student’s t-test with SPSS 16.0.
RESULTS Complete tumor resection (R0/R1) and iliac artery reconstruction were achieved in all 15 patients. All the operations were successful, with no serious complications or perioperative death. Resection with bilateral iliac artery reconstruction required a higher intraoperative blood transfusion volume than resection with unilateral iliac artery reconstruction. Recurrent cases were more likely to bleed and required a higher blood transfusion volume than primary cases. As of January 2021, 11 patients were alive, and 4 had died. Local recurrence occurred in two patients, one of whom developed liver metastasis.
CONCLUSION Resection of RPS involving iliac vessels is feasible and effective when performed by MDT members. Iliac artery oncovascular resection and reconstruction are key to a successful operation. Adequate blood preparation is important for successful completion of surgery.
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Affiliation(s)
- Wen-Xiang Li
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China
| | - Han-Xing Tong
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Chen-Tao Lv
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China
| | - Hua Yang
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China
| | - Gang Zhao
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Wei-Qi Lu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yong Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Kobayashi H, Ohashi R, Ujita M, Ueki K, Seki R, Fukuda S, Rubin B. Synchronous Occurrence of Advanced Gastric Carcinoma with Retroperitoneal Liposarcoma: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2022; 23:e934586. [PMID: 34996885 PMCID: PMC8754007 DOI: 10.12659/ajcr.934586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gastric carcinoma (GC) remains one of the most common and deadly neoplasms in the world. Liposarcoma (LPS) is the most common sarcoma of adults. However, synchronous or metachronous occurrence of GC with LPS seems to be very rare. Tumor staging and differential diagnosis with these cases are extremely difficult. CASE REPORT The patient was a man in his 70s, who reported anorexia and weight loss of 4 kg over 2 months. Gastroscopy demonstrated a large tumor of Borrmann type 3, of which histology was moderately to poorly differentiated adenocarcinoma. The clinical stage was initially defined as IVb due to a 11×6 cm retroperitoneal (RP) tumor. Despite chemotherapy for GC, the RP tumor rapidly enlarged. Endoscopic ultrasound-guided fine-needle aspiration biopsy showed that it was an undifferentiated sarcoma. He died of hepatorenal failure secondary to severe jaundice. The autopsy revealed a synchronous occurrence of GC and RP sarcoma. GC had no areas admixed with sarcoma. Histology of RP sarcoma showed that it mainly consisted of undifferentiated sarcoma and focally of well-differentiated LPS characterized by well-differentiated adipocytes admixed with scattered atypical stromal cells. The tumor cells in both areas were positive for MDM2 and CDK4 by immunohistochemistry. The diagnosis of the RP sarcoma was revised to dedifferentiated LPS. CONCLUSIONS There were no previous case reports of synchronous occurrence of GC with LPS in the English and Japanese literature. GC and LPS pose challenging problems in their diagnoses, staging, and treatments when they occur synchronously or metachronously.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Pathology, Tachikawa General Hospital, Nagaoka, Niigata, Japan
| | - Riuko Ohashi
- Histopathology Core Facility, Niigata University Faculty of Medicine, Niigata City, Niigata, Japan
| | - Masuo Ujita
- Department of Radiology, Tachikawa General Hospital, Nagaoka, Niigata, Japan
| | - Kana Ueki
- Department of Gastroenterology, Tachikawa General Hospital, Nagaoka, Niigata, Japan
| | - Ryouya Seki
- Department of Gastroenterology, Tachikawa General Hospital, Nagaoka, Niigata, Japan
| | - Shintaro Fukuda
- Department of Gastrointestinal Surgery, Tachikawa General Hospital, Nagaoka, Niigata, Japan
| | - Brian Rubin
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
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