A 58-year-old man from Delhi visited Sir Ganga Ram Hospital as he suffered from heaviness and swelling(distension) in his right abdomen. He had noticed the swelling only two weeks earlier but was surprisingly asymptomatic, experiencing no pain, loss of appetite, discomfort, weakness, weight loss, etc.
After investigating his case at the Sir Ganga Ram Hospital, it was revealed that he had a huge abdominal mass predominantly fat-containing with multiple enhancing soft tissue components and septations on his right abdomen during a CECT scan.
His right kidney and liver were displaced upwards, pancreas and adjacent small intestines loops towards the extreme left side of the abdomen. The large intestine was spread over the mass and his right ureter displaced upwards and towards the left side of the abdomen, causing the right kidney to swell.
Another complication included the location of the mass to be near the inferior vena cava ( the largest vein that carries all the deoxygenated blood from the lower parts of the body, including the abdomen to the heart)
These observations led the doctors to believe that it could be retroperitoneal liposarcoma, a malignant tumor.
This mass can be removed by surgery, but the inferior vena cava must not get damaged. The right kidney and the large bowel must also be preserved.
Dr Manish K Gupta, Vice Chairman, and Senior Laparoscopic & General Surgeon at Sir Ganga Ram Hospital, decided to operate on this patient and led the surgical team, while the vascular surgeons Ajay Yadav and Dhruv Agarwal were on standby. This complicated surgery lasted for 8 hours while the doctors ensured to separate the mass from critical organs like the duodenum, pancreas, inferior vena cava, etc.
The successful surgery lasted for 8 hours. It was a humongous task, we were able to preserve all the vital organs like the right kidney and large intestine by doing meticulous dissection and separating the tumor from the vital structures like the duodenum, pancreas, and ureter. The vascular surgery team played a pivotal role in separating the tumor mass from the inferior vena cava which was densely adherent to it and further handed over to the surgical team for the complete removal of tumor mass.
Dr Manish K Gupta, Vice Chairman; Senior Laparoscopic; General Surgeon, Sir Ganga Ram Hospital, Delhi
The mass removed measured 37 x 23 x 16 cm. This tumor is classified as a rare giant retroperitoneal liposarcoma.
After surgery, the patient was closely monitored in the ICU and then after three days, he was moved to a regular room. Seven days after the surgery, he was discharged after being fully recovered.
(Input from various sources)
(Rehash/Gayatri Prakasan/MSM)
