En bloc resection of giant retroperitoneal liposarcoma involving the right colon – a video vignette

We present a video vignette illustrating an en bloc resection of a giant retroperitoneal liposarcoma (RPLS) involving the right kidney and colon in a 65-year-old woman (Video S1). She presented with a 2-month history of non-specific abdominal pain. Abdominal CT scan showed a large retroperitoneal tumour. A biopsy was performed and the histopathological diagnosis was RPLS. At laparotomy, a mass of 20 9 23 9 25 cm was removed en bloc with the right kidney and right colon. A stapled sideto- side ileocolic anastomosis was done. The histopathological diagnosis was of well-differentiated RPLS (sclerosing and adipocytic variety) with MDM2 gene amplification. The patient was discharged on the eighth postoperative day. After 5 years of follow-up, she is alive and disease-free. RPLS is usually associated with a high rate of recurrence. In the absence of effective systemic therapies, surgery represents the mainstay of treatment with curative intent and complex multivisceral resections are frequently required. Studies have demonstrated that the prognosis of patients with RPLS is better when surgeons adopt an aggressive surgical approach [1–5]. Contiguous organs need to be resected en bloc with the tumour, even if they are not clearly infiltrated by RPLS. Because the best chance of cure is at the time of primary surgery, this rare and complex malignancy should be managed by an experienced surgical team in a specialized referral centre [2,4,5]. As the colon is one of the organs more frequently involved, surgery for RPLS should be carried out by sarcoma surgeons with experience in colorectal surgery.