Challenging retrovesical mass in men: report of a rare liposarcoma case with concurrent COVID-19 infection

BMJ Case Rep. 2021 Mar 2;14(3):e241466. doi: 10.1136/bcr-2020-241466.

Abstract

We describe a case of retrovesical liposarcoma in a male patient with concurrent COVID-19. A 50-year-old man had lower urinary tract symptoms and dull pain along his right gluteus. Due to COVID-19 infection, management was delayed. During self-isolation, the patient developed urinary retention and his pain level was an eight on the Visual Analogue Scale. A urinary catheter and an epidural catheter were inserted without any difficulty. Abdominal-pelvic MRI revealed a retrovesical mass suspected of liposarcoma with clear borders from surrounding organs. Following two consecutive negative SARS-CoV-2 PCR tests, we proceeded with surgery. Histopathology was dedifferentiated liposarcoma. Postoperatively, the patient suffered reactivation of COVID-19, and he was eventually discharged after two consecutive negative results on the PCR test on Post Operative Day (POD)-10. Retrovesical dedifferentiated liposarcoma is rare and considered as high-grade liposarcoma. Although surgery may exacerbate COVID-19 infection, surgical resection of symptomatic high-grade sarcoma is prioritised and performed as soon as no infection detected.

Keywords: COVID-19; cancer intervention; pathology; radiology; surgery.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 / therapy
  • Chemoradiotherapy, Adjuvant / methods
  • Dissection / methods
  • Humans
  • Liposarcoma* / pathology
  • Liposarcoma* / physiopathology
  • Lower Urinary Tract Symptoms* / diagnosis
  • Lower Urinary Tract Symptoms* / etiology
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Pelvic Neoplasms* / pathology
  • Pelvic Neoplasms* / physiopathology
  • SARS-CoV-2 / isolation & purification*
  • Surgical Procedures, Operative / methods*
  • Time-to-Treatment
  • Treatment Outcome
  • Urinary Retention* / diagnosis
  • Urinary Retention* / etiology