Objective:

To describe a rare retroperitoneal spindle cell liposarcoma presenting with malignant bowel obstruction and the treatment approach used.

Approach:

• Diagnosis: A 64-year-old woman underwent imaging, biopsy, and staging. Spindle-cell histology and MDM2 amplification supported spindle cell liposarcoma; imaging showed multifocal retroperitoneal and related disease.
• Management: After returning five months later with tumor progression and partial large-bowel obstruction from sigmoid encasement, she received endoscopic self-expanding colonic stenting, followed by doxorubicin and dacarbazine for unresectable disease.

Key Findings:

• Initial resection was deferred because the disease was multifocal and anatomically extensive.
• Follow-up was interrupted amid lack of insurance, unaffordable medications, and reported transportation difficulties.
• Endoscopic stenting relieved symptoms; the team selected it to avoid the roughly two-week recovery period expected after diverting colostomy before systemic therapy.

Interpretation:

The authors describe stenting as a palliative option for selected patients with unresectable malignant obstruction, weighing anatomy, clinical status, operative risk, and the potential delay to systemic treatment against stent-related complications.

Limitations:

• This is a single case and cannot establish comparative effectiveness of stenting versus surgery.
• The case report cannot establish the effectiveness or safety of stenting beyond this patient's reported symptom relief.

Conclusion:

The case illustrates the diagnostic rarity of retroperitoneal spindle cell liposarcoma and the individualized management of obstruction in unresectable disease.

Sources:

• Article context provided by the user