Another Addition to Abdomen’s Pandora’s Box: Multi-compartment Enormous Liposarcoma

Abstract Soft tissue sarcomas constitute less than 1% of all neoplasms, with a third of malignant tumours in the retroperitoneum being sarcomas and liposarcoma being the commonest. Local aggressiveness and clinical non-specificity make treatment challenging. A 52-year-old man presented with a massive lump in the abdomen. Surgery following work-up indicated a well-differentiated retroperitoneal liposarcoma (RPLS) with intraperitoneal and scrotal extension and weighed a substantial 6.8 kg. Treatment required meticulous local resection preserving the functionality. RPLS manifests as a large, locally advanced lesion with intraperitoneal extension, but extension into the inguinal canal is unknown. Being low grade, distant metastasis is infrequent, and the challenge lies in achieving effective local control and preventing local recurrence. The preferred treatment involves radical resection incorporating en bloc resection of involved structures. Strategic neoadjuvant and adjuvant therapies, tailored to specific tumour histology, may enhance local control and overall survival. Radical resection of the tumour from the mesentery of the large and small bowel, preserving their vascularity along with retroperitoneal component, albeit in parts, was achieved and is the first-line cure in RPLS. In select cases, individualised chemotherapy and radiation therapy may offer a survival benefit.