Surgical Management of a Giant Retroperitoneal Liposarcoma Presenting with Progressive Abdominal Distension: A Case Report

Abstract

Background: Retroperitoneal liposarcoma is a rare malignant soft-tissue tumour of mesenchymal origin that often remains clinically silent until it attains a considerable size. Owing to its deep anatomical location and nonspecific presentation, diagnosis is frequently delayed, making surgical management challenging. Case Presentation: A 50-year-old man with a history of hiatal hernia surgery presented with progressive abdominal distension over six months, associated with compressive symptoms and a weight loss of 7 kg. Physical examination revealed a massive abdominal mass. Ultrasonography demonstrated a large heterogeneous retroperitoneal lesion compressing adjacent abdominal organs. Contrast-enhanced computed tomography identified a giant retroperitoneal fatty mass measuring 36 × 20 × 27 cm, displacing neighbouring viscera without evidence of distant disease. Laboratory investigations, including tumour markers, were within normal limits. Owing to concerns regarding tumour dissemination, preoperative biopsy was not performed. The patient underwent complete en bloc surgical excision of the tumour through a midline laparotomy. Histopathological examination confirmed the diagnosis of sclerosing liposarcoma. The postoperative course was uneventful, and the patient was placed on regular radiological surveillance. Conclusion: Giant retroperitoneal liposarcomas are uncommon tumours that may reach enormous dimensions before diagnosis. Cross-sectional imaging plays a pivotal role in preoperative assessment, whereas complete surgical resection remains the cornerstone of treatment and offers the best chance for local disease control. Long-term follow-up is essential because of the high risk of local recurrence.