title: En-bloc resection of a giant retroperitoneal lipoma: a case report and review of the literature.
abstract: BACKGROUND
  Retroperitoneal lipomas are an extremely rare condition with only 17 cases described in the literature since 1980. They can reach enormous size and cause significant abdominal symptoms. The most important differential diagnosis is the well-differentiated liposarcoma, which preoperatively often may not definitely be ruled out.
  
  
  METHODS
  We present the case of a 73 year-old Caucasian patient with a giant retroperitoneal lipoma of 9 kg measuring 55 cm in diameter. The patient presented with abdominal pain and swelling that had been slowly progressive for the last 15 years. On computerized tomography an immense retroperitoneal tumor was revealed. Intraoperatively, the tumor did not show any signs of infiltrative growth, therefore sole tumor extirpation was performed.
  
  
  CONCLUSIONS
  Retroperitoneal lipomas are not clearly distinguishable from well-differentiated liposarcomas on imaging and even biopsies may be misleading. Moreover, abdominal symptoms, i.e. pain, obstipation and dysphagia may occur due to mechanical displacement. Therefore, surgical exploration with complete oncological resection is the therapy of choice if malignity cannot be ruled out.
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Campus Grosshadern, Ludwig Maximilians-University, Marchioninistraße 15, D-81377, Munich, Germany. Maximilian.Weniger@med.uni-muenchen.de.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Weniger
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Campus Grosshadern, Ludwig Maximilians-University, Marchioninistraße 15, D-81377, Munich, Germany. Jan.DHaese@med.uni-muenchen.de.
authors.forename: Jan G
authors.initials: JG
authors.lastname: D'Haese
authors.affiliation: Institute for Clinical Radiology, Campus Grosshadern, Ludwig Maximilians-University, Munich, Germany. Wolfgang.Kunz@med.uni-muenchen.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kunz
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Campus Grosshadern, Ludwig Maximilians-University, Marchioninistraße 15, D-81377, Munich, Germany. Sebastian.Pratschke@med.uni-muenchen.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Pratschke
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Campus Grosshadern, Ludwig Maximilians-University, Marchioninistraße 15, D-81377, Munich, Germany. Markus.Guba@med.uni-muenchen.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Guba
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Campus Grosshadern, Ludwig Maximilians-University, Marchioninistraße 15, D-81377, Munich, Germany. Jens.Werner@med.uni-muenchen.de.
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Campus Grosshadern, Ludwig Maximilians-University, Marchioninistraße 15, D-81377, Munich, Germany. Martin.Angele@med.uni-muenchen.de.
authors.forename: Martin K
authors.initials: MK
authors.lastname: Angele
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008067:Lipoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000601:surgery*