case_images: PMC9593116_01
case_images: Axial (A) and coronal (B) CT scan sections showing a large, circumscribed retroperitoneal tumor, with mass effect on the adjoining organs. The ureter crosses the tumoral tissue right in the middle. CT: Computed tomography
case_images: RJME-63-1-237-fig1.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig1.jpg
case_images: F1
case_images: The impact on the surrounding organs indicated the medial displacement of the left colon (Figure 1, A and B; Figure 2, A and B).
case_images: (A and B) 3D CT reconstruction demonstrating the mass effect produced on the left colon, urinary bladder, and the impact on the left ureter, which appears to be deformed in the lumbar segment. 3D: Three-dimensional; CT: Computed tomography
case_images: RJME-63-1-237-fig2.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig2.jpg
case_images: F2
case_images: The impact on the surrounding organs indicated the medial displacement of the left colon (Figure 1, A and B; Figure 2, A and B).
case_images: (A and B) MRI sections revealed a massive adipose tumor, which is modifying the local anatomy. Some more dense structures with irregular shapes can be observed in these images. The ureter is crossing the tumor right thru the middle, and the urinary bladder is compressed and deviated from the usual place. MRI: Magnetic resonance imaging
case_images: RJME-63-1-237-fig3.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig3.jpg
case_images: F3
case_images: The MRI also identified three small fatty spots with irregular margins and contrast enhancement (Figure 3, A and B).
case_images: Gross appearance of the whole tumoral tissue demonstrating a yellow, greasy cut surface (A) and a section through one of the suspect nodules (B) described by the radiologists. The pathologists separately examined the nodules having a different consistency
case_images: RJME-63-1-237-fig4.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig4.jpg
case_images: F4
case_images: Complete excision respecting the oncological goals was practiced (Figure 4, A and B; Figure 5). Upon dissection, the three solid masses described on MRI were identified and separately sent for HP examination (Figure 4B).
case_images: Intraoperative aspect after excising the 6.4 kg giant retroperitoneal mass. The intraperitoneal and retroperitoneal organs were entirely preserved
case_images: RJME-63-1-237-fig5.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig5.jpg
case_images: F5
case_images: Complete excision respecting the oncological goals was practiced (Figure 4, A and B; Figure 5).
case_images: Microscopic aspects of the lipoma tumor: (A) Adipocytes with variable size separated by conjunctive septa with variable thicknesses; (B) Thick fibrous septa with moderate chronic inflammation; (C) Area of conjunctival septa with nonspecific granulomatous inflammation and vascular congestion; (D) Tumor tissue with a poor vascular network; (E) Tumor tissue with low Ki67 proliferation index. HE staining: (A-C) x100. Immunolabeling with anti-CD34 antibody: (D) x100. Immunolabeling with anti-Ki67 antibody: (E) x100. CD34: Cluster of differentiation 34; HE: Hematoxylin-Eosin
case_images: RJME-63-1-237-fig6.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig6.jpg
case_images: F6
case_images: Axial (A) and coronal (B) CT scan sections at 12 months follow up reveals no signs of tumor recurrence. On the 3D reconstruction (C), it can be observed that even though all the organs regained their anatomical positions, the ureter still presents some deformations with normal renal function. 3D: Three-dimensional; CT: Computed tomography
case_images: RJME-63-1-237-fig7.jpg
case_images: PMC9593116_01_RJME-63-1-237-fig7.jpg
case_images: F7