Images in Clinical Medicine

Retroperitoneal Sarcoma

Lena M. Napolitano, M.D.

N Engl J Med 2004; 350:493January 29, 2004

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A 73-year-old man had sudden, intermittent lower abdominal pain, and he noted that his abdominal girth was increasing. Computed tomographic scans of his abdomen (Panel A) and pelvis (Panel B) revealed an extensive mass (arrows) extending from the right upper quadrant of the retroperitoneum to the pelvis. A percutaneous needle biopsy of the mass was performed, and examination of the specimen revealed features consistent with a sarcoma. Successful resection required removal of the mass in two segments (Panel C), which together weighed 6100 g. In addition, small sarcomas (2 to 3 mm in diameter) on the right abdominal peritoneal surface and the right subhepatic area were resected. Histologic examination (Panel D) confirmed that the lesion was a myxoid liposarcoma. The patient was discharged from the hospital on postoperative day 12. Three years later he underwent successful resection of a recurrent liposarcoma. He had a second recurrence after an additional two years but declined treatment.

Lena M. Napolitano, M.D.
University of Maryland School of Medicine, Baltimore, MD 21201

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