Presentation
Epigastric pain.
Patient Data
The gallbladder contains several mobile calculi measuring up to 14 mm in diameter. The common bile duct is not dilated.
In the left abdomen, there is a large mass measuring 14.5 cm in diameter, with regular borders and some internal flow, displacing the left kidney medially.
The stomach is moderately distended. Many loops of small bowel are dilated up to 3.5 cm in diameter, with air-fluid levels and gradual dilution of intraluminal contrast material. There is a transition point in the left abdomen. Most probably small bowel obstruction due to adhesion(s).
Vascular solid mass in the left retroperitoneum measuring 14.6 x 12.2 x 14.1 cm, with small internal foci of fat. The mass does not appear to emanate from the left kidney but rather from the perirenal space and displaces the kidney anteriorly. Mild peritumoral fat stranding. Findings most compatible with retroperitoneal liposarcoma.
Simple left renal cortical cyst 2.7 cm in length.
Case Discussion
The patient was taken to laparoscopic surgery, where many adhesions were found in the right lower abdomen. Adhesiolysis was performed. No sign of bowel ischemia.
The left retroperitoneal mass was excised along with the left kidney.
Pathology confirmed the mass to be a liposarcoma.