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BMJ Case Reports 2018; doi:10.1136/bcr-2018-225616
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Giant abdominal metastasis from cardiac liposarcoma

Open Access
  1. Maurizio Cervellera1
  1. 1Emergency Surgery, University of Bologna, Bologna, Italy
  2. 2Pathological Anatomy, University of Bologna, Bologna, Italy
  1. Correspondence to Professor Valeria Tonini, valeria.tonini{at}unibo.it
  • Accepted 2 June 2018
  • Published 10 July 2018

Description 

The patient was a 58-year-old man. His history began 6 years before the admission to our hospital because of a syncopal episode. MRI showed a 2 cm lesion at the confluence of the left pulmonary veins. It was surgically removed and the histopathological diagnosis was of ‘pleomorphic liposarcoma’. The postoperative course was regular.

Since the patient lived in a rural area, he was not treated in a high-volume reference centre for sarcoma and follow-up was not managed by a dedicated multidisciplinary team. Three years later, for the onset of an intestinal occlusion, he underwent emergency laparotomy. An ileo-ileal invagination due to a little ileal lesion was treated with a 30 cm intestinal resection. The histopathological response was again of liposarcoma. Chemotherapy was not performed.

One year later, a thoracoabdominal CT scan showed a heart recurrence and an enormous abdominal mass involving many ileal loops with intestinal subocclusion. The patient was evaluated in a reference centre for sarcoma and he was deemed inoperable.

Because the symptomatology progressively worsened with continuous episodes of melena and severe anaemia, he showed up at our emergency department in extremely critical condition. Thoracoabdominal CT scan confirmed both abdominal and cardiac recurrences (figure 1). An emergency life-saving surgery …

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