Management of Giant Retroperitoneal Liposarcoma with Parathyroid Adenoma

Abstract

A 44yrs gentleman presented with complaints of upper abdominal fullness for the past 7 months. Per abdominal examination led to a provisional diagnosis of Retroperitoneal or Intra-abdominal Lipoma. CECT was indicative of the same. The histopathology from the USG-guided biopsy was not definitive of liposarcoma and lipoma was suspected. Exploratory Laparotomy was performed to excise the tumor which weighed about 7.25kg and measured about 52x34x14cm, the provisional diagnosis from biopsy was lipomatous tumor. The histologic appearance was bland like lipoma, molecular studies for MDM2 were advised considering the size and location of the tumor. The results from MDM2 mutation study was suggestive of Liposaroma. Follow-up USG was done 5 months later, which showed possibility of recurrence so PET-CT was advised. PET-CT showed recurrence in retroperitoneum and in left inguinal region. The PET-CT also revealed a parathyroid adenoma (left superior) with associated symptoms. Parathyroidectomy was done electively.