A case of liposarcoma derived from fatty tissue around the inferior mesenteric artery resected by combined aortic resection.

Abstract

The prognosis of sarcoma is poor; only radical resection with a negative margin has curative potential. We report a case of liposarcoma with complete surgical resection including the abdominal aorta. A 70-year-old man visited his doctor with the chief complaint of left abdominal distention. A computed tomography scan showed a mass of 15 cm, and the patient was referred to our hospital. The inferior mesenteric artery ran through the center of the tumor. The tumor surrounded the abdominal aorta, in close to the inferior vena cava, left iliopsoas muscle, left kidney, duodenum, and marginal arteries of left colon. We diagnosed the tumor as a sarcoma originated from the mesentery membrane, with invading the retroperitoneum, but with no unresectable factors. Radical surgical resection combined with aortic resection was performed. The tumor was histopathologically diagnosed as dedifferentiated liposarcoma, and was in close to surgical margin but not exposed. The patient could be discharged without major complications. Combined resection including the abdominal aorta was considered an acceptable procedure. On the other hand, the patient had a recurrence at 10 months postoperatively and died at 12 months, and techniques to ensure surgical margin and perioperative treatment may need to be considered to improve outcomes.