Well-Differentiated Liposarcoma of the Retroperitoneum with Dedifferentiation and Multiple Recurrences: Case Report
Introduction: Retroperitoneal liposarcomas are rare mesenchymal neoplasms, with well-differentiated and dedifferentiated liposarcomas being most common. The well differentiated subtype can undergo dedifferentiation to higher grade tumors. These are difficult neoplasms to treat surgically because the...
| Autores: | , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2023 |
| País: | Brasil |
| Institución: | Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
| Repositorio: | Revista Brasileira de Cancerologia (Online) |
| Idioma: | portugués inglés español |
| OAI Identifier: | oai:rbc.inca.gov.br:article/3626 |
| Acceso en línea: | https://rbc.inca.gov.br/index.php/revista/article/view/3626 |
| Access Level: | acceso abierto |
| Palabra clave: | lipossarcoma neoplasias retroperitoneais recidiva desdiferenciação celular oncologia cirúrgica liposarcoma neoplasias retroperitoneales recurrencia desdiferenciación celular oncología quirúrgica retroperitoneal neoplasms recurrence cell dedifferentiation surgical oncology |
| Sumario: | Introduction: Retroperitoneal liposarcomas are rare mesenchymal neoplasms, with well-differentiated and dedifferentiated liposarcomas being most common. The well differentiated subtype can undergo dedifferentiation to higher grade tumors. These are difficult neoplasms to treat surgically because they have high rates of local recurrence, some subtypes can metastasize, and are poorly responsive to radiotherapy and chemotherapy. Case report: Female patient, 45 years old, presented abdominal pain and palpable abdominal mass in 2017. She underwent resection of well-differentiated liposarcoma of the retroperitoneum, without intercurrences. In 2020, she manifested abdominal pain and weight loss. Tomography showed multiple voluminous abdominal masses, with biopsy suggestive of dedifferentiated liposarcoma. The patient was submitted to neoadjuvant radiotherapy, followed by surgical resection of the masses and right ileocolectomy. In 2022, she presented symptoms suggestive of intestinal obstruction, and underwent laparotomy that revealed intense blockage of intestinal loops, duodenal fistula, retroperitoneal tumor, and fecal peritonitis. Retroperitoneal neoplasm resection, ileostomy and fistula closure were performed. Histopathology showed relapsed dedifferentiated liposarcoma. The patient evolved with operative and infectious complications, requiring intensive care and antibiotic therapy. After clinical improvement, the patient was discharged with enteral diet and continues under outpatient follow-up. Conclusion: Retroperitoneal liposarcoma may undergo multifocal dedifferentiation and recurrence, requiring several surgical approaches, increasing morbidity and the risk of complications. Wide margin surgery remains the main therapeutic modality. |
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