Metastatic giant pleomorphic retroperitoneal liposarcoma in a pregnant woman with HIV: A case report

Abstract

Background: Liposarcomas and leiomyosarcomas are the most common histological types of retroperitoneal sarcomas, followed by undifferentiated soft tissue sarcomas in adults.
Case presentation: A 38-year-old, gravida 4 para 3 HIV-positive, presented at 13 weeks of gestation to the antenatal ward as a referral with an ultrasound diagnosis of a retroperitoneal mass. Abdominal examination revealed a tender, firm mass in the left upper quadrant, extending to the left flank and fixed to the underlying structures. The abdomen's magnetic resonance imaging revealed a large soft tissue mass in the left retroperitoneum, with local invasion suggestive of a soft tissue sarcoma. She was put on analgesics, antiemetics, intravenous fluids, and total parenteral nutrition, with a plan for an ultrasound- guided biopsy of the mass and exploratory laparotomy. Her condition deteriorated, and subsequently arrested and succumbed eighteen days postadmission. The histological analysis of the postmortem specimen revealed a pleomorphic metastatic liposarcoma.
Conclusion: Retroperitoneal liposarcomas are rare and often present a diagnostic and treatment challenge. Therefore, a high index of suspicion should be indicated in women who present with abdominal masses.