Giant transverse colonic mesenteric mucinous liposarcoma combined with rectal cancer and aortic coarctation: A case report and review of literature.

Background: Liposarcomas (LPSs) are malignant mesenchymal tumors originating from adipocytes. Myxoid LPS (MLPS), a common subtype, predominantly arises in the extremities, retroperitoneum, and deep soft tissues, with a rare occurrence in the gastrointestinal tract. Primary mesenteric LPS is particularly uncommon, especially in the transverse colonic mesentery.

Case summary: This report describes the case of a 65-year-old female patient who presented with abdominal distension and was diagnosed with a giant mucinous LPS of the transverse colonic mesentery. Upon admission, the patient underwent a comprehensive evaluation. Contrast-enhanced computed tomography (CT) of the chest and abdomen revealed a large malignant tumor with aortic dissection, while colonoscopy identified rectal cancer. Given the patient's condition and surgical risk, an interventional procedure was first performed to manage the aortic coarctation, followed by tumor resection via laparotomy. Intraoperative and histopathological findings confirmed a giant mucinous LPS originating from the transverse colon mesentery. Postoperatively, the patient underwent chemotherapy and regular follow-up CT. Although the rectal tumor did not recur, the mesenteric tumor showed extensive recurrence, compressing the intestinal lumen and causing mechanical obstruction, which severely threatened the patient's life. A second operation temporarily relieved the obstructive symptoms; however, it had a limited effect on tumor progression. The patient died four months later due to disease progression.

Conclusion: While no standardized treatment exists for MLPS co-occurring with multiple diseases, operation remains the mainstay. However, recurrence, metastasis, and poor postoperative prognosis continue to pose serious threats to patient survival.