Hüseyin AYTAÇ, Nurkan TÖRER, Merve ÖZEN, İlker ARER

Dev Liposarkom için Organ Koruyucu Cerrahi

Malign yumuşak doku tümörleri olan liposarkomlar retroperitonda ve karın içinde sessiz klinikleri nedeniyle genellikle büyük boyutlarda karşımıza çıkmaktadır. Tedavide altın standart geride tümör bırakmadan yapılacak eksizyondur. Burada, ameliyat edilmiş karın içi dev bir liposarkom olgusu sunulmaktadır. Bilgisayarlı tomografide tüm karnı dolduran yer yer solid alanlar içeren bir yumuşak doku tümörü saptadı. Alınan tru-cut biyopsi bunun iyi diferansiye bir liposarkom olduğunu gösterdi. 15 kg ağırlığında ve 44x30x14 cm boyutundaki kitle tek parça halinde eksize edildi. Patolojik incelemede tümörün miksoid alanlar içeren iyi diferansiye bir liposarkom olduğu anlaşıldı. Ek tedavi olmaksızın iki yıllık sürede hastalık tekrarlaması gözlenmedi. Olgumuz literatürde sunulmuş en büyük retroperiton yerleşimli liposarkomlardan birisidir.

Anahtar Kelimeler:

Dev liposarkom, retroperitoneal kitle, intra-abdominal kitle

Organ Sparing Surgery for a Giant Liposarcoma

Liposarcomas those are malignant soft tissue tumors often occur in large sizes in the retroperitoneum and abdomen due to their silent clinic. Excision with negative margins is the gold standard of treatment. A case operated on for a giant intraabdominal liposarcoma is being reported. A giant soft tissue tumor filling the whole abdomen was determined in the computed tomography scan. Core biopsy was obtained and demonstrated a well-differentiated liposarcoma. A 15 kg of mass 44x30x14 cm in size was excised en-bloc. Pathological examination of this tumor showed a well-differentiated liposarcoma with mixoid parts. No recurrence was observed in two years of follow-up despite any adjuvant therapy. This is to be one of the largest retroperitoneal sarcomas in the literature

Keywords:

Giant liposarcoma, retroperitoneal mass, intra-abdominal mass,

PDF

___

Francis IR, Cohan RH, Varma DGSondak VK. Retroperitoneal sarcomas. Cancer Imaging 2005;5:89.
Inoue K, Higaki YYoshida H. Giant retroperitoneal liposarcoma. Int J Urol 2005;12:220-2.
Sharma M, Mannan R, Bhasin TS, Manjari MPunj R. Giant Inflammatory Variant of Well Differentiated Liposarcoma: A Case Report of a Rare Entity. J Clin Diagn Res. 2013;7:1720.
Doglietto GB, Tortorelli AP, Papa V, Rosa F, Bossola M, Prete FP, et al. Giant retroperitoneal sarcomas: a single institution experience. World J Surg. 2007;31:1047-54.
Thomas J. Retroperitoneal sarcoma. Br J Surg. 2007;94:1057-8.
Hassan I, Park SZ, Donohue JH, Nagorney DM, Kay PA, Nasciemento AG, et al. Operative management of primary retroperitoneal sarcomas: a reappraisal of an institutional experience. Ann Surg. 2004;239:244.
An J, Heo J, Noh J, Sohn T, Nam S, Choi S, et al. Primary malignant retroperitoneal tumors: analysis of a single institutional experience. Eur J Surg Oncol. 2007;33:376-82.
Jelinek J, Kransdorf M, Shmookler B, Aboulafia AMalawer M. Liposarcoma of the extremities: MR and CT findings in the histologic subtypes. Radiology. 1993;186:455-9.
Fernández-Ruiz M, Rodríguez-Gil Y, Guerra-Vales JM, Manrique-Municio A, Moreno-González EColina- Ruizdelgado F. Primary retroperitoneal liposarcoma: clinical and histological analysis of ten cases. Gastroenterol Hepatol. 2010;33:370-6.
Pereira JM, Sirlin CB, Pinto PSCasola G. CT and MR Imaging of Extrahepatic Fatty Masses of the Abdomen and Pelvis: Techniques, Diagnosis, Differential Diagnosis, and Pitfalls 1. Radiographics. 2005;25:69-85.
Nijhuis PH, Sars PR, Plaat BE, Molenaar WM, Sluiter WJHoekstra HJ. Clinico-pathological data and prognostic factors in completely resected AJCC stage I-III liposarcomas. Ann Surg Oncol. 2000;7:535-43.
Grimer R, Judson I, Peake D Seddon B. Guidelines for the management of soft tissue sarcomas. Sarcoma. 2010;2010:506182.
Singer S, Antonescu CR, Riedel EBrennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg. 2003;238:358.
Lahat G, Anaya D, Wang X, Tuvin D, Lev DPollock R. Resectable well-differentiated versus dedifferentiated liposarcomas: two different diseases possibly requiring different treatment approaches. Ann Surg Oncol. 2008;15:1585-93.
Binder SC, Katz BSheridan B. Retroperitoneal liposarcoma. Ann Surg. 1978;187:257.
Lazar A, Brãtucu EStraja N. Prognostic factors for the primary and secondary retroperitoneal sarcomas. Impact on the therapeutic approach. Chirurgia (Bucur). 2012;107:308-13.
Shibata D, Lewis JJ, Leung DHBrennan MF. Is there a role for incomplete resection in the management of retroperitoneal liposarcomas? J Am Coll Surg. 2001;193:373-9.
Le Pechoux C, Pautier P, Delannes M, Bui B, Bonichon F, Bonvalot S, et al. Clinical practice guidelines: 2006 update of recommendations for the radiotherapeutic management of patients with soft tissue sarcoma (sarcoma of the extremity, uterine sarcoma and retroperitoneal sarcoma). Cancer Radiother. 2006;10:185-207.
Mullinax JE, Zager JSGonzalez RJ. Current diagnosis and management of retroperitoneal sarcoma. Cancer Control. 2011;18:177-87.