Apollo Cancer Centre, successfully performed a rare surgery to treat recurrent retroperitoneal sarcoma and removed 44 cm sized tumour, weighing 8.4kg. The patient was a 54-year-old woman from Bangladesh with complaints of abdomen distension for six months and reduced appetite and abdomen discomfort after food intake.
In the past, the patient was operated on for similar complaints. Post evaluation with PET CT imaging, it was found there was a huge mass occupying predominantly right retroperitoneum from under surface of liver to upto the pelvis and extending into all quadrants of the abdomen. The doctors planned the next step for an abdominal surgery with a multidisciplinary team involving a surgical oncologist, vascular surgeon, urologist, cardiologist, anaesthesiologist, and intensive care team.
The team was led by Dr Ajit Pai, Consultant- GI Surgical Oncology & Robotic Surgeon, Apollo Cancer Centre Chennai. The tests revealed multiple lesions arising from the retroperitoneum, small intestine mesentery, and transverse colon mesentery. The largest portion was densely adherent to the right kidney posteriorly and involved 50 cm of long segment of small intestine (ileum) and entire right colon. The doctors, post detailed discussions, created an extensive plan of treatment to remove the tumour. The masses were removed all at the same time, along with the right kidney, small intestine, and right colon, which measured about 44 cm in length and weighed about 8.4 kg. In addition to it, multiple other masses were removed ensuring complete clearance of tumour from the abdomen. Patient was observed in the intensive care unit for 24 hours and started on oral diet on day 4. Postoperative recovery was uneventful, and the patient was discharged after a week without any complications.
Dr Ajit Pai, Consultant- GI Surgical Oncology & Robotic Surgeon, Apollo Cancer Centre Chennai, said “Retroperitoneal sarcomas are rare tumours accounting for only 1 - 2% of all solid malignancies. Of all sarcomas, the majority occur outside of the retroperitoneum. This case was extremely rare and challenging in terms of a recurrent disease close to major vessels and involving the large intestine and small intestine requiring multivisceral resection and achieving a margin free excision.”