Hüseyin BİLGE, Ömer BAŞOL, Mehmet RENÇBER, Gizem YAMAN, Abdullah OĞUZ

Treatment management of giant retroperitoneal localized liposarcoma

Liposarcoma is a tumor that reaches large diameters inside soft tissue tumors. It is rare. It is more common in people between the ages of 40-60. Liposacoma patients are mostly asymptomatic, so their diagnosis may be delayed.A 65-year-old female patient was admitted to our clinic. She had complaints of mass and pain in her abdomen. Abdominal examination revealed a mass extending to the pelvic area. The patient was evaluated by examination and radiology. Retroperitoneal liposarcoma diagnosed. Since the mass captured the left colon and kidney, the patient underwent left nephrectomy and left hemicolectomy. After histological and immunohistochemical examination, the patient was diagnosed with well-differentiated liposarcoma. The patient was evaluated with abdominal and pelvic computed tomography at the postoperative 4th month. No recurrence was observed in computed tomography scans. With the review of the literature, we found that the giant well-differentiated liposarcoma case extending into the pelvic region was scarce. In this study, a rare case with giant well-differentiated liposarcoma that fills the abdomen almost completely is presented and the clinical features and surgical management of these tumors are discussed.

Dev Retroperitoneal Liposarkomun Tedavi Yönetimi

Liposarkom, yumuşak doku tümörlerinde büyük çaplara ulaşan bir tümördür. Nadirdir. 40-60 yaşları arasındaki kişilerde daha yaygındır. Liposarkom hastaları çoğunlukla asemptomatiktir, bu nedenle tanıları gecikebilir. 65 yaşında bayan hasta kliniğimize başvurdu. Karnında kitle ve ağrı şikayetleri vardı. Karın muayenesinde, pelvik bölgeye kadar uzanan kitle vardı. Hasta muayene ve radyolojik olarak değerlendirildi. Retroperitoneal liposarkom tanısı kondu. Kitle sol kolon ve böreği ivvaze ettiği için hastaya sol nefrektomi ve sol hemikolektomi ameliyatı yapıldı. Histolojik ve immünohistokimyasal incelemeden sonra hastaya iyi diferansiye liposarkom teşhisi kondu. Hasta postoperatif 4. ayda karın ve pelvik bilgisayarlı tomografi ile değerlendirildi. Bilgisayarlı tomografi taramalarında nüks gözlenmedi. Literatürün gözden geçirilmesiyle pelvik bölgeye uzanan dev iyi diferansiye liposarkom olgusunun az olduğunu bulduk. Bu çalışmada, karnı neredeyse tamamen dolduran dev iyi diferansiye liposarkomlu nadir bir olgu sunulmuştur ve bu tümörlerin klinik özellikleri ve cerrahi yönetimi tartışılmıştır.

PDF

___

1. McGuinness LA, Floyd Jr MS, Lucky M, et al. Myxoid liposarcoma of the scrotum in a 27-year-old male successfully treated with primary excision and testis preservation. Journal of Clinical Urology. 2015; 8: 285-6. https://journals.sagepub.com/doi/abs/10.1177/2 051415813514970

2. Chrisinger JS, Al‐Zaid T, Keung EZ, et al. The degree of sclerosis is associated with prognosis in welldifferentiated liposarcoma of the retroperitoneum. Journal of Surgical Oncology. 2019; 120: 382-8. https://onlinelibrary.wiley.com/doi/full/10.1002/j so.25585

3. Baum SH, Mohr C. Metastases from distant primary tumours on the head and neck: clinical manifestation and diagnostics of 91 cases. Oral and Maxillofacial Surgery. 2018; 22; 119-28. https://link.springer.com/article/10.1007/s10006 -018-0677-y

4. Seelig MH, Winkels R, Wiese M, Weyhe D. Spermatic cord liposarcomas incidentally found during hernia surgery: is histology of any lipoma mandatory? A review of the literature. Acta Chirurgica Belgica. 2020; 120: 79-84. https://www.tandfonline.com/doi/full/10.1080/0 0015458.2019.1689645

5. Spieler P, Rössle M. Kidney, Adrenal Glands, Retroperitoneum In Nongynecologic Cytopathology. Berlin, Heidelberg: Springer, 2012: 731-95.

6. Yorke J, Agbenorku P, Awoonor-Williams R, et al. Management of Retroperitoneal Liposarcoma: A Case Report. Surgical Science. 2016; 7: 361. https://www.scirp.org/html/6- 2301046_69985.htm

7. Sari SY, Cengiz M, Dauletkazin A, et al. Hypofractionated radiotherapy for non-metastatic bone and soft tissue sarcomas. Cancer/Radiothérapie. 2019; 23: 853-9. https://www.sciencedirect.com/science/article/pii /S1278321819303932

8. Van Houdt WJ, Raut CP, Bonvalot S, et al. New research strategies in retroperitoneal sarcoma. The case of Tarpswg, Strass and Resar: making progress through collaboration. Curr Opin Oncol. 2019; 31: 310–6. https://journals.lww.com/cooncology/ fulltext/2019/07000/new_research_stra tegies_in_retroperitoneal.12.aspx

9. Rasulov RI, Dvornichenko VV, Muratov AA, Songolov GI, Mozgunov DV. İnorganik retroperitoneal tümörler: geçmiş ve şimdiki. Sibirya Tıp Dergisi (Irkutsk). 2015; 138. https://mir.ismu.baikal.ru/src/downloads/e4957c 16_4_smzh_7_2015(s5-56).pdf

10. Neoplasien AP. 9.Neoplasien des Unterhautbindegewebes (primäre und metastatische). Rheumatologie C: Spezieller Teil II Wirbelsäule, Weichteile, Kollagenerkrankungen, 2013; 330. https://books.google.com.tr/books?hl=tr&lr=&id= nAmgBgAAQBAJ&oi=fnd&pg=PA330&dq=Neoplasi en+A.+P.+9.+Neoplasien+des+Unterhautbindegewe bes+(prim%C3%A4re+und+metastatische).+Rheu matologie+C:+Spezieller+Teil+II+Wirbels%C3%A4 ule,+Weichteile,+Kollagenerkrankungen,+2013%3 B330.&ots=dSLuXGnNw7&sig=SsC7VrpG2Ykj6ScF VTPepABy0gM&redir_esc=y#v=onepage&q&f=false

11. Brenneman R. J., Sharifai N., Fischer-Valuck B., et al. (2019). Abscopal effect following proton beam radiotherapy in a patient with inoperable metastatic retroperitoneal sarcoma. Frontiers in Oncology, 9, 922. https://www.frontiersin.org/articles/10.3389/fon c.2019.00922/full

12. Lee HS, Yu JI, Do Hoon Lim SJK. Retroperitoneal liposarcoma: the role of adjuvant radiation therapy and the prognostic factors. Radiation oncology journal. 2016; 34: 216. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5 066451/

13. Akpak YK, Gün İ, Kaya N, Atay V. A rare case of leiomyoma: Retroperitoneal leiomyoma. Dicle Tıp Dergisi. 2014; 41: 414-17. https://dergipark.org.tr/tr/download/articlefile/ 53872