Asian Journal of Research in Surgery

Background: Primary mesenteric myxoid liposarcoma is an exceedingly rare malignant tumour arising from mesenteric adipose tissue. It poses diagnostic challenges due to its nonspecific clinical presentation and imaging resemblance to other intra-abdominal masses such as gastrointestinal stromal tumours or mesenteric cysts.

Case Presentation: We report the case of a 23-year-old woman who presented with dull aching abdominal pain, nausea, and a palpable lower abdominal mass for six months. Imaging with ultrasonography and contrast-enhanced CT revealed a large, well-defined mixed solid-cystic lesion arising from the transverse mesocolon, suggestive of a soft tissue sarcoma. The patient underwent complete surgical excision of the tumour via midline laparotomy. Histopathological examination confirmed the diagnosis of myxoid liposarcoma (FNCLCC Grade 1). The postoperative course was uneventful, and the patient remained asymptomatic during follow-up with no evidence of recurrence.

Conclusion: Primary mesenteric myxoid liposarcoma, though rare, should be considered in the differential diagnosis of large intra-abdominal masses. Cross-sectional imaging assists in preoperative assessment, but histopathology remains definitive. Complete surgical excision with negative margins is the mainstay of treatment, and long-term follow-up is essential due to the potential for late recurrence.