CASE REPORTS   

Chirurgia 2007 October;20(5):269-71

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

An unusual retroperitoneal leiomyosarcoma: a case report

Antonino A., Guida F., Formisano G., Esposito D., Conte P., Celiento M., Mastrobuoni G., Aprea G., Avallone U.

Dipartimento di Chirurgia Generale, Geriatrica, Oncologica e Tecnologie Avanzate Facoltà di Medicina e Chirurgia Università degli Studi di Napoli Federico II, Napoli

Soft tissue sarcomas are malignant tumors that may arise in any of the mesodermal tissues of the extremities (50%), trunk and retroperitoneum (40%), or head and neck (10%). Retroperitoneal sarcomas have vary clinical courses depending on their histologic subtype and grade: approximately half of retroperitoneal sarcoma are high-grade tumors and most are liposarcoma (41%), leiomyosarcoma (28%), malignant fibrous histiocytoma (7%), fibrosarcoma (6%), and malignant peripheral nerve sheath tumor (3%). Surgery is the standard treatment for retroperitoneal sarcomas but complete margin-negative resections can be difficult to achieve because of their large size and the complexity of the retroperitoneal anatomy. Radiation therapy is widely used as an adjuvant therapy to surgery but it is more problematic in the treatment of retroperitoneal sarcomas. Preoperative radiation therapy has the theoretical advantages of using the tumor’s bulk to displace uninvolved intraabdominal viscera out of the radiation field, thereby decreasing local toxicity and increasing the ability to administer therapeutic radiation doses. Postoperative external-beam radiation at the doses that are most likely to be effective can be associated with acute and delayed bowel toxicity. We report the case of an 60-year-old man whith a long history of ingravescent lower limb edema, an abdominal mass and loss of weight who was found to have a large retroperitoneal mass confirmed to be a leiomyosarcoma. The clinical features are outlined and in addition the treatment and prognosis.