Dedifferentiated Liposarcoma Case Study Dr. Emily Keung and Dr. Edwin Choy

In this case study video, Dr. Emily Keung and Dr. Edwin Choy discuss the treatment of a 50-year-old female.

Take our patient case study curated for you by our editorial panel members Drs. Emily Keung and Edwin Choy:

A 50-year-old woman presents with several year history of increasing abdominal girth, early satiety and weight loss.

No significant medical or surgical history.
Physical Exam: presence of a large intraabdominal mass.
CT imaging: a large retroperitoneal tumour (having both lipomatous and solid components), causing mass effect with displacement and compression of intraabdominal/ retroperitoneal organs.
No evidence of pulmonary metastasis on CT chest portion.
Biopsy of the higher grade/dense tumour – dedifferentiated liposarcoma with MDM2 amplification
Albumin: 3.3g/mL, prelab 5.5mg/dL, CRP 94mg/L

Prognosis: 7-year OS 31% and 7-year DFS 10%

Initial Treatment

Exploratory laparotomy and radical resection of tumor with right nephroureterectomy, partial colectomy, resection of psoas fascia.
Postoperative gastroparesis requiring PEG placement for venting and period of TPN- which gradually resolved and G tube removed.

Surveillance

CT imaging of chest, abdomen and pelvis at 3 months interval

Outcome

No evidence of disease for 2 years, however developed recurrence at pancreas head

What could be the optimal treatment option for this individual at this stage?

a) Systemic therapy

b) Preoperative radiation followed by surgery

c) Definitive radiation therapy

According to the current guidelines from ESMO (European Society for Medical Oncology) and TARPSWG (Transatlantic Retroperitoneal Sarcoma Working Group), for the management of retroperitoneal sarcomas, what is the recommended setting?

a) Primary care clinics

b) General hospitals with surgical departments

c) Sarcoma reference centres and/or within reference networks

d) Oncology outpatient facilities

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