Retroperitoneal Sarcomas

Abstract

Retroperitoneal sarcomas present technical difficulties in their resection. The tumors are discovered when they are quite advanced locally, and their complete surgical resection is difficult because of their large size, inaccessible location, and infiltration of adjacent retroperitoneal structures. Often the patient or the physician will palpate a large, asymptomatic abdominal mass, or the diagnosis is triggered by mild abdominal pain or discomfort. In the pelvis, pressure by the tumor on the femoral nerve may cause pain in the distribution of this nerve in the anterior thigh and/or the anterior leg (via the saphenous branch of femoral nerve), or in the lateral thigh (lateral femoral cutaneous nerve), or medial thigh (obturator nerve), or groin (genitofemoral nerve). Pressure on the iliac vein may cause swelling of the ipsilateral extremity. Preoperative CT scans of the abdomen and pelvis or MRI tends to outline the extent of the tumor and its location quite effectively. A chest x-ray and preferably a CT scan of the chest are also performed, to rule out the presence of pulmonary metastases.