A Case of Retroperitoneal Dedifferentiated Liposarcoma with Stenosis of the Bile Duct

Abstract

A 38-year-old man with retroperitoneal dedifferentiated liposarcoma was treated by retroperitoneal tumor resection. Two months after the surgery, abdominal enhanced CT revealed a nodular lesion in the hepatoduodenal ligament and stenosis of the bile duct. We diagnosed persistence of the residual lipsarcoma with stenosis of the bile duct, because the nodular lesion was also detected in the abdominal CT obtained before the first operation, and performed subtotal stomach-preserving pancreaticoduodenectomy. Histopathologically, the dedifferentiated liposarcoma involved the entire hepatoduadenal ligament and the resection margin was microscopically positive for tumor cells. This is the first reported case of retroperitoneal dedifferentiated liposarcoma causing stenosis of the bile duct. We thought that the retroperitoneal liposarcoma invading the hepatoduodenal ligament formed the nodular lesion constricting the bile duct. The tumor was completely resected macroscopically, however, the resection margin was microscopically positive for tumor cells. It would seem that evaluation of the invasive extent of a liposarcoma is difficult based on either preoperative imaging findings or the intraoperative findings. Therefore, it is important to try and prevent R2 resection and detect recurrences as early as possible.