A Case of Liposarcoma of the Ascending Colon Treated with Robot-assisted Right Hemicolectomy

Abstract

The patient was an 88-year-old man who had missed a follow-up clinic appointment after a colonoscopy revealed a submucosal tumor in the ascending colon. Two years later, a computed tomography showed a mass in the ascending colon, and a colonoscopy revealed a type 1 lesion. A biopsy suggested poorly differentiated adenocarcinoma, and the patient underwent a robot-assisted right hemicolectomy with D3 lymph node dissection. During surgery, the tumor was found to have invaded the parietal peritoneum, which was subsequently resected. There were severe adhesions between the head of the pancreas, the duodenum, and the mesentery of the colon, making dissection challenging. Histopathology confirmed the diagnosis of dedifferentiated liposarcoma of the ascending colon. Tumor cells had invaded the adipose tissue around the lymph nodes, the proximal resection margin, and the abdominal wall. A recurrent lesion was detected in the small bowel mesentery 9 months postoperatively.

Liposarcomas originating from the colon are extremely rare, as liposarcomas typically arise from soft tissues such as the limbs and retroperitoneum. Colonic liposarcomas tend to grow rapidly and invade, and local recurrence is frequent, often necessitating extensive resection of adjacent tissues. We report this case of dedifferentiated liposarcoma of the ascending colon.