Retroperitoneal Liposarcoma – A Rare Surgery

A 55 year old gentleman had been presented with complaints of abdominal swelling and vague abdominal pain and admitted under the care of Dr. Oindrila Biswas (Consultant Surgical Oncologist). After thorough evaluation relevant investigations were done where the CT Abdomen revealed a huge well defined heterogeneous retroperitoneal lipomatous tumour (19.6 cm X 18.0 cm X 24.0 cm) and biopsy revealed liposarcoma (Malignant tumour). After discussion with the family and with written and informed consent, the gentleman had been posted for surgery. On exploration it was found that the tumour was occupying whole of the right side of abdomen crossing to left side, with abutment of the right renal hilum. R0 resection (without any residual tumour) was achieved without any major organ resection, and with minimal blood loss. The tumour measured 35 cm X 25 cm and weighing around 9 kgs. The postoperative period was uneventful and the gentleman had been discharged on sixth post operative day.

This is a rare surgery as retroperitoneal sarcomas are rare tumours, having an incidence of only 0.3 - 0.4 % new cases per one lakh population. It is a technically demanding surgery because it tends to involve many major organs, like in this case it was the right kidney, Inferior Vene Cava (IVC) and colon. The pre requisites of such surgeries are pre operative surgical planning, team and techniques.