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Surg Case Rep. 2019 Feb 4;5(1):18. doi: 10.1186/s40792-019-0576-y.

Two-stage surgery for intraperitoneal and retroperitoneal multicentric liposarcoma causing hydronephrosis: a case report.

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Department of Surgery, Otaru General Hospital, 047-8550, 1-1-1, Wakamatsu, Otaru-shi, Hokkai-do, Japan.
Department of Gastroenterological Surgery I, Hokkaido University Hospital, 060-8648, Nishi 5 chome, Kita 14 jyo, Kita-ku, Sapporo-shi, Japan.
Department of Surgery, Otaru General Hospital, 047-8550, 1-1-1, Wakamatsu, Otaru-shi, Hokkai-do, Japan.



Liposarcoma is a soft tissue sarcoma of adipocyte origin. Liposarcoma represents 20-30% of adult soft tissue tumors, which was most frequently seen in the retroperitoneal space in 45% and abdominal space in only 5% of cases, but the multicentric case is unknown. Herein, we describe a rare case of multicentric, large, intra-abdominal and retroperitoneal liposarcoma, one of which had caused infection and pressing the right ureter causing hydronephrosis, which was resected by two-stage surgery.


The patient was a 46-year-old man who was referred for abdominal bloating and fatigue. Enhanced computed tomography showed a 23-cm intra-abdominal tumor and a 14.6-cm left retroperitoneal tumor. The intra-abdominal tumor which compressed the right ureter caused right unilateral hydronephrosis and deteriorated the renal function. The intra-abdominal tumor had also formed an intra-abdominal abscess. We performed emergent laparotomy and resected the intra-abdominal tumor. After the recovery of renal function, we resected the residual retroperitoneal tumor. Histopathological examination showed both tumors to be myxoid/round cell type liposarcoma. Considering clinical findings and their location, he was diagnosed with multicentric liposarcoma. He underwent adjuvant chemotherapy and has been alive without any recurrence for 9 months after the operation.


We successfully resected large intra-abdominal and retroperitoneal multicentric myxoid/round cell liposarcomas. A two-stage surgery was a rational choice as it provides time to confirm the recovery of renal function.


Intra-abdominal; Liposarcoma; Multicentric; Myxoid; Retroperitoneal; Round cell


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