Case 6

This is a non-contrast CT study of the abdomen and pelvis showing a large mass in the right side of the abdomen extending to the pelvis; the mass is heterogeneous, showing mainly macroscopic fatty density – yet it includes a few soft tissue density elements. The mass displaces the right kidney and the peritoneal sac anteromedially, placing it in the retroperitoneum. There is no infiltration of the right kidney.

This is a primary retroperitoneal mass showing the characteristic features of a liposarcoma. The differential diagnosis includes an angiomyolipoma arising from the right kidney (although it is not felt to be arising from the kidney) and retroperitoneal teratoma.

In the first instance I would communicate the findings to the referring physician, and recommend an image guided core biopsy- the anterior soft tissue component would be the optimal target. I would then recommend that the case be discussed at surgical MDT once the histopathology results are obtained.