58 years old male patient presented to us with heaviness and distension of abdomen more on the right side of abdomen which he noticed only 2 weeks back. He met a physician and was asked for a CECT whole abdomen (15.6.2024) after examination. He was absolutely unaware of the fact that he was carrying a very large tumour mass of more than one foot size even bigger than a size of football in his abdomen. Other than this surprisingly he was absolutely fit and asymptomatic having no pain  or discomfort in the abdomen, loss of appetite, body weight loss or weakness.

 

He was further investigated at Sir Ganga Ram Hospital, Delhi and a very large abdominal mass was noted in the right side of the abdomen reported as a large predominantly fat containing mass with multiple enhancing soft tissue component and septations displacing the right kidney & liver upwards and pancreas and adjacent small intestinal loops towards the extreme left side of abdomen. The large intestine was splayed over the mass in its full length. His right ureter was also pushed upwards and towards the left side of abdomen leading to swelling of the right kidney. This mass was also in very close proximity of the inferior vena cava, the largest vein which returns the deoxygenated blood from lower half of the body and abdomen to the heart. The findings were suggestive of retroperitoneal liposarcoma. 

 

Anticipating the criticality of the surgery of such a huge mass and the challenges not to damage the the inferior vena cava and preserving right kidney and large bowel, the surgical team headed by Dr Manish K Gupta, Vice chairman & Senior Laparoscopic & Gen Surgeon, Sir Ganga Ram Hospital, Delhi took the decision to operate the patient and keeping the Vascular Surgical team standby comprising of Dr Ajay Yadav and Dr Dhruv Agarwal. The successful surgery lasted for 8 hours. It was a humongous task, the surgeons were able to preserve all the vital organ like right kidney & large intestine by doing meticulous dissection and separating the tumour from the vital structures like duodenum, pancreas and ureter. Vascular surgery team did the pivotal role in separating the tumour mass from the inferior vena cava which was densely adherent to it, and further handed over to surgical team for the complete removal of tumour mass.

 

A large retroperitoneal mass of size 37 X 23 X 16 cm weighing 7.5 kgs was taken out and sent for biopsy. Any tumour of more than 30 cm in size comes into the category of Giant retroperitoneal mass and is quite rare. Patient was shifted to post op ICU after the surgery. After 3 days patient was shifted to room where he recovered well and got discharged from Sir Ganga Ram Hospital after 7 days of surgery.

 

58-year-old’s 7.5 kg tumor excised: Giant 37 x 23 x 16 cm retroperitoneal liposarcoma successfully removed in 8-hour surgery

Dr Manish K Gupta, Vice chairman & Senior Laparoscopic & Gen Surgeon, Sir Ganga Ram Hospital, Delhi led the intricate operation, preserving vital organs amidst a massive 7.5 kg tumor

 

Dr. Ajay Yadav and Dr. Dhruv Agarwal expertly separated the tumor from the inferior vena cava during surgery

Post-surgery, the 58-year-old patient was discharged 7 days later, underscoring the exceptional care at Sir Ganga Ram Hospital