Myxoid liposarcoma of sigmoid mesocolon: a case report and review of the literature.

BACKGROUND: Liposarcoma is a malignant mesenchymal tumor most commonly arising in the extremities and retroperitoneum. Involvement of the mesentery is rare, and primary liposarcoma of the large bowel mesentery has been reported fewer than 15 times in the English literature. Among its histological subtypes, myxoid liposarcoma is exceptionally rare in this location, with only four previous cases described. Owing to its rarity, there are no standardized management protocols, although wide surgical excision with negative margins remains the mainstay of treatment.

CASE PRESENTATION: We report a 73 year-old Arab male with hypertension and ischemic heart disease who presented with painless abdominal swelling and anorexia. Imaging revealed a large left mesocolon mass, and a left hemicolectomy with colosigmoid anastomosis achieved R0 margins. Histopathology confirmed primary myxoid liposarcoma of the mesocolon. The patient had an uneventful recovery and remains disease-free 1 year after surgery.

CONCLUSION: Primary myxoid liposarcoma of the mesocolon is extremely rare, with this case representing only the fifth reported instance. Review of the literature indicates that complete surgical resection is the cornerstone of management, while the role of adjuvant radiotherapy or chemotherapy remains controversial. Reporting additional cases is essential to improve understanding, refine prognostic assessment, and guide the development of evidence-based treatment strategies.