Giant Retroperitoneal Liposarcoma- Renal Salvage by Autotransplantation

Abstract

Liposarcomas are the most common retroperitoneal soft tissue tumors. We here in report a case of giant retroperitoneal sarcoma which weighed 24 kgs. Renal autotransplant of right kidney was done for organ preservation. The patient has done well after a follow up of 63 months. Complete surgical resection with organ preservation is the goal of treatment in patients with retroperitoneal liposarcomas.Keywords Giant retroperitoneal liposarcoma . Renal preservation . Autotransplantation Liposarcoma is the most common soft tissue sarcoma in adults and accounts for at least 10-20 % of all sarcomas. These tumours are usually late to be detected because of absence of symptoms in retroperitoneum and reach a large size (>15 cm) by time of diagnosis [1]. Complete surgical resection is treatment of choice. There are many case reports in the literature of giant retroperitoneal liposarcomas, the largest reported so far weighed 42 kg [2]. We herein report a case of retroperitoneal liposarcoma which was 24 kg in weight and autotransplantation of one kidney was done. Case Report52 years male presented with complaints of progressive abdominal distension, early satiety, weight loss and dyspnoea. Abdomen was distended by a large mass occupying whole abdomen (Fig. 1). His haemoglobin was 8 g % and renal functions were normal. Chest x-ray was normal. Contrast enhanced computed tomography (CECT) showed a mass occupying the abdomen with no infiltration of kidneys or major vessels (Fig. 2).At laparotomy, a giant 40×35×35 cm solid tumour was completely filling the abdomen (Fig. 3). 50 cm of ileum and right middle ureter were adherent to tumour. Bilateral kidneys and other intra-abdominal organs were free. Enbloc resection of the tumour along with adherent ileum and ureter was done. The bowel was reanastomosed and right kidney was autotransplanted in left iliac fossa. Tumour weighed 24 kg. Patient was discharged after 7 days. Histopathology revealed a mixed type of liposarcoma.CECT abdomen after 6 months showed no recurrence and 99m Tc Diethylene Triamine Penta-acetic acid (DTPA) scan showed good renal function in autotransplanted kidney. Patient presented again after 40 months, with a tumour recurrence in right iliac fossa. 10×15 cms tumour was found adjacent to right iliac vessels which was excised and he

Clinicopathological characteristics and experience in the treatment of giant retroperitoneal liposarcoma: A case report and review of the literature

“…In English literature, from 1975 to Octobor 2016, only 13 cases of giant RPLS have been reported (Table 1). [6][7][8][9][10][11][12][13][14][15][16][17][18] Of the 14 patients (including ours), there were 9 male (64.3%) and 5 female (35.7%) with a median age of 53 (39-72) years and they all presented atypical clinical manifestations such as abdominal distention or increasing in abdominal girth. All the 14 giant RPLS were diagnosed by CT scan.…”

Autotransplantation of the kidney in surgery of retroperitoneal sarcomas

“…В настоящее время стало возмож-ным проведение органосохраняющих приемов [5]. В мировой литературе существуют единичные сообщения об успешном выполнении процедуры аутотрансплантации почки как варианта завер-шения операции по удалению ретроперитонеаль-ной саркомы [6,7]. Первая аутотрансплантация почки была выполнена J.D.…”

Minimally invasive renal autotransplantation

“…In children, the major indication was synchronous Wilms tumor . Lastly, a few groups reported on the use of ReATx as an effective treatment strategy for managing large ureteral defects secondary to encasement by abdominal malignancies including metastatic germ cell tumors and liposarcomas and one case report demonstrated the use of ReATx for organ preservation against inadvertent radiation exposure (Fig. ) .…”