Well-differentiated abdominal liposarcoma

Case contributed by Melissa Arias sanz
Diagnosis almost certain

Presentation

Increased volume in the right testicle, abdominal and testicular pain, abdominal bloating, satiety before eating, constipation and blood in the stool.

Patient Data

Age: 60 years
Gender: Male

A 14.7 x 13.4 x 22.6 cm extraperitoneal mass of fatty tissue in the right anterior pararenal space with changes in the density of the encapsulated fat, effacement of the fatty planes and the presence of gas inside, which causes a mass effect with displacement towards the left of the bladder and the ileum.

Extension of the mass at the level of the right hemiscrotum with measurements of 12 x 6 x 9 cm and a volume of 336 cc that communicates through the inguinal canal with the ipsilateral anterior pararenal space.

Case Discussion

Well-differentiated abdominal liposarcoma, a rare malignant mesenchymal neoplasm of adipose tissue, usually painless and slow growing, requires imaging studies to evaluate extent, invasion, and classification, primarily CT and MRI. The heterogeneity of the images reflects variable proportions of fat, tissue, and cells in the tumor. Diagnostic confirmation is through biopsy, allowing its evaluation and classification. Multidisciplinary collaboration is essential for treatment planning and improving outcomes.

Well-differentiated Liposarcoma was suspected, so a biopsy of the invasive tissue was performed, macroscopically showing a yellow encapsulated fatty tumor. Analysis of the sample microscopically confirmed the suspicion of well-differentiated liposarcoma.

No invasion of the renal, adrenal or pancreatic parenchyma was observed, and there was no presence of other abdominal masses or proliferation towards vascular tissue or the muscular wall.

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