Oncologists of the Herzen Institute performed a unique operation to remove a giant liposarcoma using autotransplantation of the kidney

The most complicated operation to remove a giant retroperitoneal liposarcoma with autotransplantation of the kidney was performed at the P.A. Herzen Moscow State Medical Research Institute – a branch of the Federal State Budgetary Institution “NMIC of Radiology” of the Ministry of Health of Russia. The team of doctors brilliantly coped with their task, preserving the work of vital organs.

Our patient is a resident of the Republic of Mordovia – a young woman of 51 years. She turned to the NMIC of Radiology with complaints about the presence of a bulky formation in the abdomen and perineum. She was tormented by constant pain and heaviness in her stomach, nausea, difficulty eating, had problems with stool and urination. It all started in 2017, when she was diagnosed with omission and prolapse of the pelvic organs. However, she did not receive any special treatment. Since January 2020 she noted a rapid increase in the size of the abdomen. Having turned to a therapist at the place of residence, she was sent for examination to the Republican Oncological Dispensary of Mordovia. It was there that she was confirmed to have a voluminous multi-node formation of the large abdominal cavity with the involvement of the left kidney and a retroperitoneal non-organ malignant tumor was confirmed. Immediately after the diagnosis, the patient was referred for consultation and treatment at the FSBI “NMIC of Radiology” of the Ministry of Health of Russia.

During pre-examination and direct examination at the P.A. Herzen Moscow State Medical Institute, it was noted that the tumor reaches gigantic sizes and spreads from the level of the diaphragm to the pelvic cavity, occupies the entire abdominal cavity, involving the left kidney in the tumor masses with a change in its position, as well as vital vascular structures – the aorta, arterial branches of the abdominal trunk, feeding the stomach, liver, spleen, pancreas. In addition, the situation was complicated by the patient’s irreparable loss of pelvic organs along with tumor masses. The total size of the tumor was 40x35x30cm.

The doctors of the P.A. Herzen Moscow Medical Institute took up this most difficult case, which was accompanied by a huge number of risks associated with the loss of one or more vital organs and a large blood loss. The medical consultation, which was personally headed by the Director General of the FSBI “NMIC Radiology” of the Ministry of Health of the Russian Federation, Academician of the Russian Academy of Sciences A.D. Kaprin and Deputy Director General for Surgery, MD A.B. Ryabov, was attended by extra-class specialists – anesthesiologists, resuscitators, transplantologists, blood transfusion specialists, oncourologists, chemotherapists and radiotherapists.

During the operation, which lasted almost 12 hours, the patient had a retroperitoneal non-organ tumor removed with partial removal of the pancreas, spleen, left dome of the diaphragm, left half of the colon, removal of the uterus with appendages and the formation of a suspended enterostomy, autotransplantation of the kidney cleared of tumor masses. Surgeons were not only able to completely remove the tumor, but also to preserve the work of a vital organ – the patient’s own kidney. The operating team was attended by: Deputy Director General for Surgery, Doctor of Medical Sciences A.B. Ryabov, Head of the Department of Abdominal Oncology, MD D.V. Sidorov, a team of transplantologists led by the head of the group of transplantation and renal replacement Therapy of the Lopatkin Research Institute of Urology and Interventional Radiology, MD S. V. Arzumanov, Head of the Department of Kidney Transplantation and Vascular Surgery in Urology A. E. Mitish, Senior researcher Department of Anesthesiology and Resuscitation, MD M.M. Shemetova, anesthesiologist D.S. Sheremet, Senior Researcher of the thoracoabdominal Department, PhD I.V. Kolobaev, Researcher of the Thoracoabdominal Department, PhD A.V. Chaika, oncologists – Ph.D. A.B. Utkina, A.A. Khadzhamkulov, M.S. Gusakova; secondary medical staff: anesthesiologist H.M. Kamilova, operating nurses T.V. Biryukova and G.V. Timofeeva.

Today, our patient is undergoing postoperative rehabilitation in the intensive care unit, her condition corresponds to the timing and volume of the operation. We wish her a speedy recovery and good health!

The press service of the FSBI “NMIC of Radiology” of the Ministry of Health of Russia.