Liposarcomas of the Kidney and Surgical Management.

Abstract

Background/aim: Retroperitoneal liposarcomas of the kidney are rare malignancies with a poor prognosis due to a high recurrence rate and their ability to spread in the retroperitoneum before causing any noticeable symptoms. Because these tumors are so rare and their surgical removal can be complicated by the involvement of many organs and vessels inside the abdomen, there is a need for more documentation on the procedures by which surgeons remove these tumors.

Patients and methods: In this article, we describe a case series of four patients presenting with retroperitoneal liposarcomas that required surgical resection of the tumor along with radical nephrectomies. Some of these cases benefitted from liver mobilization similar to that performed during liver transplantation, in order to more clearly identify the entire scope of these large retroperitoneal tumors. Here, we demonstrate unique ways of managing such patients with these rare tumors.

Results: The operative times for patients 1, 2, 3, and 4 were 240, 249, 167, and 272 minutes, respectively. Estimated blood loss ranged from 250 to 2,000 cc, with only patients 1 and 4 requiring blood transfusions. Postoperative complications included bile leakage in patient 1 and prolonged ileus in patient 4, which resolved without further intervention.

Conclusion: Our case series underscores the importance of comprehensive surgical management in patients with large, locally advanced renal liposarcomas. Moreover, development of carefully selected individualized treatment plans including adjuvant therapy when appropriate, is critical to improve long-term survival outcomes for patients with renal liposarcoma.