Giant Atypical Spindle Cell Lipomatous Tumor of Retroperitoneal Origin Presenting with Lung Metastasis and Extension to the Thigh: A Case Report with Literature Review

Abstract

Retroperitoneal liposarcomas are rare, and their variants, atypical spindle cell lipomatous tumor (ASCLT), are rarer. Though ASCLTs are benign, they have high recurrence despite complete surgical excision. We present a rare case of a 22-year-old male presented with insidious-onset, and gradually progressive swelling over left inguinofemoral, and iliac fossa region. Also, the patients had a history of weight loss, pricking-type pain radiating to left lower limb, and breathlessness on exertion. Contrast-enhanced computed tomography (CECT) abdomen revealed a large well-defined heterogeneously enhancing soft mass located in pelvis, and involving left-sided iliopsoas muscle suggestive of retroperitoneal soft tissue sarcoma and CECT thorax showed metastasis. The CT-guided core biopsy led to the definitive diagnosis of low-grade ASCLT. Subsequently, the patient was initiated on concurrent neoadjuvant chemoradiotherapy followed by complete surgical excision. The findings in this report make it critical to enhance our understanding of this rare tumor, with surgery being the best treatment option.

Keywords

atypical spindle cell lipomatous tumor - liposarcoma - retroperitoneal - soft tissue sarcoma - spindle cell tumor

Source of Support

None.

Prior Presentation of Manuscript

None.

Authors' Contributions

P.K., S.K., P.P., V.N., and P.S. conceptualized the study and critically reviewed the study; P.K., S.K., and P.P. designed the study; S.K., P.P. supervised the study and provided material; P.K., V.N., and P.S. helped in data collection and/or processing, literature search, writing, and analysis and/or interpretation.

Declaration of the Patient Consent

Consent to write and report this case was obtained from the patient.

Publikationsverlauf

Artikel online veröffentlicht:
05. August 2024

• References

• 1 Jacob MS, Patel S, Sasken H, Perez Y, Katz V, Ingram M. Retroperitoneal liposarcoma: a case report. Int J Case Rep Imag 2014; 5 (02) 108-112
• 2 Mansour S, Azzam N, Kluger Y, Khuri S. Retroperitoneal liposarcoma: the giant type. J Med Cases 2022; 13 (10) 517-520
• 3 Gaurish SKS, Sanjay D, Vandana PG, Amruta BJ, Vaishya H. A spindle cell well differentiated liposarcoma / atypical lipomatous tumor of the neck: a rare case with immunohistochemical study. Sarcoma Res Int 2014; 1 (01) 3
• 4 Sbaraglia M, Bellan E, Dei Tos AP. The 2020 WHO classification of soft tissue tumours: news and perspectives. Pathologica 2021; 113 (02) 70-84
• 5 Panthi S, Poudel S, Khanal N. et al. Spindle cell sarcoma: a case report of diagnostic and therapeutic quandary in a low resource setting. J Surg Case Rep 2022; 2022 (01) rjab612
• 6 Hua H, He Z, Lei L. et al. Retroperitoneal spindle cell tumor: a case report. Front Surg 2021; 8: 764901
• 7 Selvam A, Pandian K, Kothe P, Vinoth M, Rekha A. Undifferentiated spindle cell sarcoma in the retroperitoneum- case report. Arch Surg Clin Case Rep 2020; 3: 147
• 8 Gutu C, Butnari V, Schiopu V. Giant retroperitoneal liposarcoma measuring 27 × 29 × 36 cm: a case report. J Surg Case Rep 2023; 2023 (01) rjac608
• 9 Salemis NS, Nisotakis K, Patouras P, Karagkiouzis G, Gourgiotis S. Retroperitoneal liposarcoma extending into the thigh. Am J Surg 2011; 201 (05) e38-e40
• 10 Lewis SJ, Wunder JS, Couture J. et al. Soft tissue sarcomas involving the pelvis. J Surg Oncol 2001; 77 (01) 8-14 , discussion 15
• 11 Shioi Y, Hasegawa T, Otsuka K. et al. Primary retroperitoneal spindle cell liposarcoma: pathological and immunohistochemical findings. Pathol Int 2010; 60 (06) 472-476
• 12 Guo J, Qiu F, Zhao J. et al. Case report: retroperitoneal sarcoma in six operations: our experience in operative management of blood vessels. Front Oncol 2022; 12: 885033