Retroperitoneal liposarcoma causing upper gastrointestinal bleeding

Abstract

Retroperitoneal sarcomas are rare tumors that usually present with abdominal discomfort and palpable mass. They rarely present with gastrointestinal bleeding. Here, we report a case of retroperitoneal liposarcoma presenting with upper gastrointestinal bleeding secondary to gastric invasion. A 70-year-old lady with recurrent history of retroperitoneal liposarcoma and multiple previous surgical resections and radiotherapy presented with melena for one week. Upper endoscopy revealed a fungating mass in the gastric body, the biopsy of which confirmed liposarcoma. Few days later, the patient developed abdominal pain and fever. CT scan of the abdomen showed perforated stomach with abdominal collection. This responded well to drainage and intravenous antibiotics. Gastric perforation following diagnostic upper endoscopy is extremely rare and mostly associated with predisposing factor like malignant tumors. Endoscopists should be aware of the risk and avoid excessive air insufflation or looping of the scope in such patients.