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Images of Memorable Cases: Case 70

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk

Case_70-pres1-1.jpg

This 49-year-old woman presented with slowly progressive, asymptomatic abdominal swelling of one year’s duration. Six years earlier, she had undergone resection of a retroperitoneal liposarcoma. On examination, her abdomen was incredibly enlarged, rock-hard, and nontender.

70. Metastatic liposarcoma

Computed tomography showed numerous non-homogeneous masses of varying density compressing and displacing but not invading contiguous abdominal and retroperitoneal organs (image below). At celiotomy, most of the neoplastic tissue was removed in three large blocks totaling 100 lbs! The histopathologic diagnosis was well-differentiated liposarcoma. Patients with this cell type can have a five-year survival rate as high as 80%, while in those with poorly differentiated lesions, survival drops to 20% or less. This patient survived for a total of nine years, ultimately succumbing to widespread metastases.

Case_70-diag1-1.jpg

Computed tomography at level of liver (A), mid-abdomen (B), and pelvis (C) after intravenous injection of contrast material. L=liver, T=tumor.

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