Rare case of retroperitoneal liposarcoma presented as perineal swelling (The tip of Iceberg)

Background: Primary typical and atypical lipomatous tumors are the most common soft tissue tumors, where liposarcomas are the most common sarcoma. They are mostly found in the retroperitoneum and extremities. Rarely these tumors could present as hernias through different hernial orifices, this case report presents a rare presentation of retroperitoneal liposarcoma presented as a perineal swelling herniating through the ischiorectal and ischioanal fossa. Case presentation: A 53 years old male patient presented to the outpatient surgery clinic in Al-Hayat National Hospital, Riyadh, kingdom of Saudi Arabia (KSA) complaining of swelling in the left gluteal area for two years, that progressively increased in size with no other symptoms. Magnetic resonance imaging (MRI) revealed a large retroperitoneal soft tissue mass lesion of fat content herniating into the perineal region. Complete surgical excision of this mass were done. Conclusions: liposarcoma herniating through ischiorectal and ischioanal fossa are rare form of retroperitoneal liposarcoma as in this case where radiology plays an important role in initial diagnosis, staging and surgical planning.