A 61-year-old woman with history of morbid obesity, open cholecystectomy, and sarcoma excision from right lower extremity and from left buttock (6 and 3 years ago, resp.) developed fatigue, abdominal pain, and large palpable mass occupying entire abdomen and right flank. A computer tomography (CT) scan showed 27 × 20 cm multilobular abdominal mass and 2.5 × 2.5 cm solid mass in the middle pole of the right kidney (Figures
Abdomen CT scan with IV and PO contrast, axial view. Large multilobular mass (red arrow).
Abdomen CT scan with IV and PO contrast, axial view. Solid mas in the right kidney (red arrow).
Surgical specimen: large retroperitoneal sarcoma involving small bowel and mesentery.
Eight months later, the patient developed intraperitoneal recurrence of sarcoma and underwent debulking surgery.
Subsequently, she developed recurrent and metastatic disease involving spleen, mesentery, liver, pelvis, and lungs and received multiple courses of chemotherapy, including Gemcitabine, Taxotere, and a clinical trial of Yondelis. Following the chemotherapy treatment described above, the patient had near complete resolution of all intra-abdominal and pulmonary nodules and currently (7 years after resection of retroperitoneal mass and nephrectomy) is recurrence-free.
Liposarcoma is one of the most common soft tissue sarcomas found in adults. It has a predilection for retroperitoneal space. Renal cell carcinoma is the most common tumor of the kidney [
The concomitant occurrence of a renal cell carcinoma and retroperitoneal sarcoma is extremely rare with only few cases being reported [
Surgical resection is the mainstay of therapy for both renal cell carcinoma and retroperitoneal sarcoma [
This case is noticeable because of the good outcome in our patient despite extremely aggressive behavior of the tumor and also because of exceptionally large size of retroperitoneal sarcoma.
The author declares that they have no competing interests.