Retroperitoneal liposarcoma

Case contributed by Dachani Kansan Naider
Diagnosis almost certain

Presentation

4 month history of increased urinary frequency with urgency and overflow incontinence.

Patient Data

Age: 60 years
Gender: Male

Abdomen + pelvis

ct

There is a large, heterogeneous, retroperitoneal mass arising from the right pelvic side wall containing both fat and soft tissue density. Imaging features suggest a large soft tissue tumor and are suspicious for a pelvic liposarcoma.

There is significant displacement of the adjacent structures:

  • The bladder is displaced superiorly and towards the left with significant stretched appearance of the bladder neck; the prostate is also displaced towards the left pelvic side wall
  • The distal ureters are displaced; this is more notable with the right ureter which is displaced over the superior margin of the mass and traverses horizontally
  • There is associated mild right hydroureter and hydronephrosis but both kidneys show expected contrast excretion on delayed phase imaging
  • The right external and internal iliac vessels appear displaced to the margins of the mass
  • The sigmoid colon is displaced to the left posterolateral aspect of mass

Case Discussion

In view of the CT scan findings above, the patient underwent a cystoprostatectomy, excision of the retroperitoneal mass and ileal conduit formation.

Histopathology confirmed a myxoid liposarcoma comprised of proliferation of abnormal adipose tissue with fibromyxoid stroma. 

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