Well differentiated giant retroperitoneal liposarcoma during the pregnancy.

A 35-year-old patient, pregnant, with history of two previous cesarean deliveries was referred to our service due the presence of an abdominal mass at 36 weeks of gestational age. The patient declined any other medical problems and stated that over the course of two years advised the growing of her abdomen but did not seek medical attention. To the physical examination she was cachectic, with the presence of an evident mass extending from the right subcostal angle and part of the left side to the symphysis pubis, displacing the gravid uterus from the midline to the left side. An ultrasound of the abdomen and pelvis revealed a fetal survey within normal limits with a biophysical profile of 8/8 and the presence of the abdominal mass displacing the intraabdominal organs. During the moment of the ultrasound survey the patient started with uterine contractions and was transferred to the labor and delivery room, reason why a magnetic resonance image was not performed. In the labor and delivery area she was found in active phase of labor. Due the history of the two previous cesarean deliveries a cesarean delivery was performed, delivering a 3,200 grams infant with no signs of wasting. The oncology team biopsied the mass with preliminary frozen section report of lipoma vs. liposarcoma. Due the patient wasting condition and lack of final histological report the debulking surgery was postponed. During the final debulking surgery a giant retroperitoneal mass found, measuring 52 x 40 x 35 cm and weighting 12,500 grams, respecting the surrounding organs (kidneys, ureter, inferior vena cava and the abdominal aorta) (Figs. 1 and 2). The final pathology report was for positive for malignancy (a well differentiated liposarcoma) with no signs of metastasis. One year after the surgery, the patient has no signs of recurrence.