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Retroperitoneal Sarcoma

Sarcoma of Retroperitoneum


Presentation

  • RESULTS: Forty-three out of 78 patients (55%) presented with primary RS. Infiltrated organs were resected in 42 patients (54%).[ncbi.nlm.nih.gov]
  • We present the second reported case of paraneoplastic glomerulopathy due to a retroperitoneal sarcoma. The patient presented with generalized edema and nephrotic syndrome. CT scan showed two large retroperitoneal masses.[ncbi.nlm.nih.gov]
  • RESULTS: Retroperitoneal tumors often present as large, locally advanced lesions. Evaluation of these tumors requires careful consideration of a multimodality approach.[ncbi.nlm.nih.gov]
  • We present a technique of hyperfractionated (192)Ir brachytherapy (HFIR) of the tumor bed via intraoperatively implanted plastic catheters. Postoperative CT-based image-guided brachytherapy was performed.[ncbi.nlm.nih.gov]
  • Abstract A 42-year-old man presented with lower abdominal pain and a vague abdominal mass. He underwent resection of a well-differentiated liposarcoma arising from his retroperitoneum measuring 50 cm and weighing 11.7 kg (25.8 lb).[ncbi.nlm.nih.gov]
Overeating
  • Preoperative RT is preferred over postoperative RT. New types and delivery techniques in radiation therapy could further improve patient outcomes.[ncbi.nlm.nih.gov]
  • RESULTS: The integral dose to the intestinal cavity was similar with the three modalities but the dose distribution was different, with a change-over around 25 Gy: the V50 and the V40 were reduced five- and twofold, respectively, with IMRT compared to[ncbi.nlm.nih.gov]
  • On the other hand, the resection rate of RPS is significantly increased over the last decades allowing to deliver the best treatment available.[ncbi.nlm.nih.gov]
  • Although there have been advances in the understanding of these tumors and their treatment over the past few years, there is still a lack of consensus on the standard of care, and new therapeutic options are eagerly awaited.[ncbi.nlm.nih.gov]
  • The morbidity of RPS resection has decreased over time despite widespread adoption of radical resection. Certain patterns of resection are associated with higher complication rates and elderly patients are at increased risk of morbidity.[ncbi.nlm.nih.gov]
Abdominal Mass
  • Abstract A huge left renal capsular leiomyoma mimicking retroperitoneal sarcoma presented in a patient as an abdominal mass.[ncbi.nlm.nih.gov]
  • Abstract A 42-year-old man presented with lower abdominal pain and a vague abdominal mass. He underwent resection of a well-differentiated liposarcoma arising from his retroperitoneum measuring 50 cm and weighing 11.7 kg (25.8 lb).[ncbi.nlm.nih.gov]
  • Clinical findings Often asymptomatic abdominal mass; average age, 50. Prognosis 65% to 80% of cases achieve complete resection; 5-year local recurrence, 50%; 5-year survival, 50%.[medical-dictionary.thefreedictionary.com]
  • RESULTS: The abdominal mass was common presenting symptom. Histologically liposarcomas(25%) and leiomyosarcomas(23.3%) were most common, and MFHs(11.7%) and malignant schwannomas(11.7%) followed. The overall 5 year survival rate was 54.6%.[e-crt.org]
Back Pain
  • Possible symptoms include abdominal pain, abdominal rigidity, back pain, swelling of lower limbs, intestinal obstruction, and an early feeling of satiation.[tasmc.org.il]
  • She started getting really bad back pains which she thought at the time was a water infection..[community.macmillan.org.uk]
Foot Drop
  • CASE REPORT: We report the case of a 59-year-old woman presenting left-sided foot drop as her initial symptom.[ncbi.nlm.nih.gov]
Renal Impairment
  • The GFR decreased by an average of 33.4 mL/min/1.73 m 2 with 66% of patients demonstrating mild progression of their renal impairment. Only three (6%) patients progressed to CKD stage 4 or 5, one of which required life-long dialysis.[ncbi.nlm.nih.gov]

Workup

  • Workup Liposarcoma. Contrast-enhanced axial CT shows large right retroperitoneal liposarcoma (arrow) composed predominantly of fat but also has areas of soft tissue density and calcific components. 10.[es.slideshare.net]
  • What the surgeon needs to know Imaging is important in the diagnostic workup of these patients, being required not only for tumor detection, staging, and operative planning, but also for guiding percutaneous or surgical biopsy of these tumors.[ncbi.nlm.nih.gov]

Treatment

  • An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. METHODS AND MATERIALS: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled.[ncbi.nlm.nih.gov]
  • The 2 objectives of this review were: 1) to determine the benefit of RT in terms of local control and/or survival in the treatment of retroperitoneal sarcomas and 2) to discover the optimal timing of RT in the treatment sequence.[ncbi.nlm.nih.gov]
  • Abstract PURPOSE OF REVIEW: Retroperitoneal sarcomas are rare tumors and with complex treatment. In this manuscript we give an overview of current standards in treatment of this disease and discuss new developments.[ncbi.nlm.nih.gov]
  • No major late effects of treatment have been observed with a follow-up of 15 and 28 months, respectively. Details of the brachytherapy procedure are presented.[ncbi.nlm.nih.gov]
  • BACKGROUND: Patients receiving cancer treatment are at risk for hepatitis B virus (HBV) reactivation. Ifosfamide is an alkylating agent and is considered to be one of the important drugs for the treatment of metastatic sarcoma.[ncbi.nlm.nih.gov]

Prognosis

  • Based on scientific literature and clinical expertise, clinicopathological data were analyzed using both a supervised and an unsupervised classification method to predict the prognosis, with similar sample sizes (66 and 65, resp., in casewise approach[ncbi.nlm.nih.gov]
  • R0 resection is the cornerstone of therapy, with local control being integral for a favorable prognosis. We present a case of giant retroperitoneal liposarcoma treated with complete surgical resection.[ncbi.nlm.nih.gov]
  • Abstract Retroperitoneal sarcomas (RPS) are uncommon tumors associated with a poor prognosis. This is particularly true in case of high-grade sarcomas of specific histological subtypes, as demonstrated by the largest surveys of the last decade.[ncbi.nlm.nih.gov]
  • Local and distant recurrent disease carries a dismal prognosis, although long-term survival can be achieved. Liposarcomas tend to recur locally, whereas distant recurrences are more often seen in leiomyosarcoma and other subtypes.[ncbi.nlm.nih.gov]
  • Long-term prognosis without complete excision is grim with average 5- and 10-year survival rates of 16.7 and 8.0 per cent. With aggressive surgical therapy survival is increased to 58.0 and 39.6 per cent.[ncbi.nlm.nih.gov]

Etiology

  • They have assembled expert authors to review the following topics: Epidemiology and Etiology of Sarcomas; Management of Extremity Sarcomas; Management of Retroperitoneal Sarcomas; Management of Dermatofibrosarcoma Protuberans; Management of Desmoids;[books.google.ro]
  • […] neoplasms arise from outside the major organs, and are divided according to histological types: mesenchymal origin : skeletal muscle, fat, peripheral nerve, vessels, fibrous tissue extra-gonadal germ cell tumors primary retroperitoneal adenocarcinoma Etiology[radiopaedia.org]

Epidemiology

  • In this report, we describe the first case, to our knowledge, in the medical literature and discuss epidemiology, diagnosis, and management.[ncbi.nlm.nih.gov]
  • METHODS: The Surveillance, Epidemiology, and End Results database was utilized to identify patients with retroperitoneal sarcomas from 2002 to 2012.[ncbi.nlm.nih.gov]
  • Our objective was to determine the effect of radiation therapy on disease-specific and overall survival between propensity score-matched surgically resected RPS patients using the Surveillance, Epidemiology, and End Results (SEER) database.[ncbi.nlm.nih.gov]
  • METHODS: The review was conducted according the recommendation of the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) group with pre-specified inclusion and exclusion criteria.[ncbi.nlm.nih.gov]
  • METHODS: We queried the Surveillance, Epidemiology and End Results (SEER) database (1988-2013) for the utilization of IORT and perioperative external beam RT (EBRT) in patients who underwent surgical resection of RPS.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Prevention

  • If possible, every spilled gallstone during surgery should be retrieved to prevent this rare complication.[ncbi.nlm.nih.gov]
  • Fear of kidney failure should not prevent a surgeon from performing a nephrectomy in the treatment of RPS. 2017 Wiley Periodicals, Inc.[ncbi.nlm.nih.gov]
  • To prevent complications of prolonged cross-clamp time and distal hypo-perfusion, circulatory support was sought to facilitate the procedure.[ncbi.nlm.nih.gov]
  • Ultimately, 4 patients (25 % of those who recurred) had isolated in-field recurrences within the hypothetical high-risk dose-painting boost volumes and that thus might have been prevented with dose-escalation.[ncbi.nlm.nih.gov]
  • The aim of non-surgical follow up treatment is to prevent the sarcoma coming back. Even if the cancer is in remission, regular check ups will be arranged so that the whole of the abdomen can be monitored closely.[chelseasurgeonsclinic.com]

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