Abstract
An 83-year-old man was admitted to our hospital with the complaints of fever and abdominal distention lasting for six days. An enhanced abdominal CT scan showed an irregular, 13-cm sized tumor of fatty tissue density with the surrounding inflammatory changes. Differential diagnoses included primary omental liposarcoma and omental torsion, and semi-emergent surgery was considered to be necessary. Extended tumor resection with ileocecal and abdominal wall resection was performed. His postoperative course was complicated with deep surgical site infection, but he recovered with conservative management and was discharged at postoperative day 47. The histopathological diagnosis was primary well-differentiated liposarcoma of the omentum.
Liposarcomas commonly affect the thigh, gluteal region, and retroperitoneum, and rarely occur in the omentum. They can be classified into five subtypes ; differentiated type, myxoid type, round cell type, pleomorphic type, and dedifferentiated type. Although the differentiated liposarcoma has relatively favorable prognosis, that of intraperitoneal origin leads to much poorer prognosis than other sites, such as extremities and back. The reasons might lie in the difficulties in resecting the tumor completely and giving adequate radiation. Surgery owes one of the most important parts of treatment for liposarcoma. We successfully resected primary omental liposarcoma with adequate margin and no recurrence was found for eleven months after the surgery.
