Surgery to remove a liposarcoma weighing nearly 4kg for a 76-year-old patient

Previously, the patient (76 years old) was hospitalized due to rapid abdominal enlargement, tension, and deformation of the right hypochondrium-costal region in the past 3 months. Clinical examination and imaging results showed a retroperitoneal mass, measuring 28x15cm, mixed structure of fat-solid tissue, pressing on the abdominal organs but showing no signs of invasion of neighboring organs. Combining clinical and imaging, the patient was diagnosed with retroperitoneal liposarcoma.

The case was assessed as high risk due to the patient's advanced age, underlying respiratory disease, and large tumor infiltrating the abdominal wall muscles. The risk of massive blood loss and hemodynamic instability during surgery was predicted.

After a multidisciplinary consultation, the patient was indicated for radical tumor removal surgery. The surgeon carefully dissected along the anatomical plane, controlling the small blood vessels to avoid damage to nearby organs. The entire tumor was removed intact, weighing nearly 4kg, measuring 28x15cm.

After surgery, the patient was actively resuscitated, hemodynamics were stable, no bleeding or surgical site infection was recorded. Histopathology results confirmed: undifferentiated liposarcoma, the resection surface was negative for tumor cells. The patient recovered well and was discharged after 7 days.

Retroperitoneal liposarcoma is a rare soft tissue malignancy, accounting for about 15–20% of retroperitoneal sarcomas. The disease progresses silently, often only detected when the tumor reaches a large size, causing compression of adjacent organs. Radical surgery with negative margins is the standard treatment, determining the prognosis of the disease. However, the local recurrence rate is high (30–50%), especially in the first two to three years after surgery. Therefore, regular monitoring by ultrasound or CT scan every 6–12 months is necessary.

Specialist II Doctor Le Van Thanh, Deputy Director of Hanoi Oncology Hospital, Head of General Surgery Department recommends that people, especially the elderly, should have regular health check-ups to detect early abnormalities in the abdomen. When seeing signs such as an unusually large abdomen, dull pain in the lumbar region, feeling a hard, mobile mass in the abdomen, you should immediately go to a specialized medical facility for examination, diagnosis and timely treatment.

Minh Hoang

Source: https://nhandan.vn/phau-thuat-cat-bo-khoi-sarcoma-mo-nang-gan-4kg-cho-benh-nhan-76-tuoi-post920276.html