case_images: PMC11271108_01
case_images: Giant abdominal masse englobing the entire abdomen.
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case_images: Physical examination revealed an enormous mass occupying all abdominal quadrants (Figure 1).
case_images: Computed tomography (CT) and magnetic resonance imaging, axial view. (A) Contrast-enhanced abdominal CT scan showing a 45 cm diameter giant intra and retroperitoneal heterogeneous tumor (blue arrows) occupying the pelvic and abdominal cavity. (B) The tumor (blue arrows) is incorporating the left kidney, ureter and adrenal gland (yellow arrows) and displacing the transverse and left colon (green arrows). (C) The mass is displacing the spleen, its pedicle and the left pancreas (with arrows). (D) Abdominal MRI showing a giant retro and intra-peritoneal, multi-loculated mass, with mixed T2 hypersignal areas and iso-signal zones heterogeneously enhanced measuring 38 cm, englobing the left kidney and displacing the adjacent structures.
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case_images: CRP at 137 mg/L, with normal tumoral markers values. Computed tomography (CT) revealed a 45 cm wild retroperitoneal mass, incorporating the left kidney and adrenal gland and displacing the aortocaval, iliac and mesenteric vascular axes alongside the small intestine, colon, spleen and liver, without infiltration (Figure 2(A)-(C)). A complementary magnetic resonance images (MRI) showed a giant retro and intra-peritoneal, multi-loculated mass, with mixed T2 hypersignal areas and iso-signal zones heterogeneously enhanced measuring 38 cm, englobing the left kidney and displacing the adjacent structures and compressing the left ureter with ureterohydronephrosis (Figure 2(D)).
case_images: Xypho pubic laparotomy revealing a giant tumor pushing forward the left colon. (blue arrows).
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case_images: A xypho-pubic laparotomy revealed a giant tumor reaching the pelvis, incorporating the left kidney, ureter and adrenal gland, and displacing without invading the transverse and left colon and englobing the splenic vein and the left pancreas (Figures 3 and 4).
case_images: Fully exposed liposarcoma.
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case_images: A xypho-pubic laparotomy revealed a giant tumor reaching the pelvis, incorporating the left kidney, ureter and adrenal gland, and displacing without invading the transverse and left colon and englobing the splenic vein and the left pancreas (Figures 3 and 4).
case_images: Resection specimen weighted at 23 kg.
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case_images: The specimen (Figure 5) was weighted at 23 kg.
case_images: Histopathological findings: (A) adipocytic tumor proliferation encompassing renal parenchyma without invasion. (B): Well-differentiated tumor proliferation showing a few atypical adipose cells mixed with non-atypical adipose cells within an inflammatory stroma. (C): Atypical adipocytic cells exhibit irregular and hyperchromatic enlarged nuclei.
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case_images: Anatomopathological analysis (Figure 6) revealed a 59 cm diameter well-differentiated lipoma-like liposarcoma that included the renal and adrenal parenchyma without invading them, and with invaded R1 excision limits, however despite that the specimen was well-marked and properly oriented the significant volume of the tumor and its multiple contacts with adjacent structures made it impossible for the pathologist to precisely determine the area of tumor residue making it difficult to determine the area for potential radiotherapy.