INCARCERATED INCISIONAL HERNIA: AN UNUSUAL PRESENTATION OF LIPOSARCOMA MYXOIDES METASTATICUM

Abstract

Abdominal wall hernia is a common condition seen in the clinical practice of surgery. Soft tissue sarcomas are rare neoplasms, representing less than 1% of tumors in adults. However, recurrent liposarcoma reason for incarcerated incisional are rare and there are limited studies on this subject. We report a case of a 43-year-old female who presented with generalized abdominal pain and vomiting. She was treated for an incarcerated incisional hernia and underwent an exploratory laparotomy, which showed a multiseptated incisional hernia sac, with small bowel loops and the presence of recurrent liposarcoma in the mesentery. Desincarceration with maximal adhesiolysis and total extirpation of the recurrent liposarcoma and abdominal wall hernioplasty were performed. Contrast-enhanced CT is the first-line investigation, complete surgical excision remains the gold standard treatment for primary and even recurrent tumors. Prognosis depends on the histological type and grade. Histopathological examination revealed a liposarcoma myxoides metastaticum. The patient had surgeries for liposarcoma three and one years ago, and appropriate oncological treatment. The operative and postoperative course were uneventful. Postoperatively, she continued with oncological treatment. Follow-up after 6 months remains clean and is ongoing. Conclusion: Liposarcomas are aggressive malignant tumors with frequent recurrences.