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Peritoneal and retroperitoneal sarcomatosis secondary to dedifferentiated intra-abdominal liposarcoma
Apresentação do caso
A 69-year-old male patient with a history of laparoscopic left total nephrectomy due to perirenal mass. Histopathology evidenced a dedifferentiated liposarcoma with components of high-degree dedifferentiated myxofibrosarcoma. On the 5-month follow-up, MR imaging revealed widespread peritoneal and retroperitoneal sarcomatosis, and the patient was referred for a surgical consult. Due to the extension of the lesions, including in the subcutaneous region of a laparoscopic scar, the case was considered inoperable. Palliative chemotherapy was then established.
Peritoneal sarcomatosis is a potential complication of nearly all solid tumors and results in profoundly increased morbidity and mortality. It’s an extremely rare site of metastatic disease which is associated with a poor prognosis and high rates of recurrence after resection. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal sarcomatosis may offer a survival benefit in selected patients and it remains a topic of debate. Although rare, cases of abdominal sarcomatosis (AS) after laparotomy/laparoscopic interventions have been reported.
Peritoneal sarcomatosis is a known, although rare, complication of surgical manipulation of intra-abdominal sarcomas. Thus, given the post-operative histopathological diagnosis, patients should be under imaging surveillance and continuously assessed for peritoneal tumor dissemination during follow-up. Prompt diagnosis and intervention may reduce its morbidity and provide better quality of life to affected patients.
Peritoneal sarcomatosis, liposarcoma, palliative chemotherapy
Sarcomas / tumores ósseos*
AMANDA DE FREITAS FERREIRA DE MOURA, JONADAB DOS SANTOS SILVA , PITTER DIAS DAMASCENO , MARCELO SÁ DE ARAUJO