TITLE:
Pouch of Douglas Liposarcoma—A Rarity
AUTHORS:
J. S. Rajkumar, Jayakrishna Reddy Aluru, Rajkumar Anirudh, Rajkumar Shreya, N. Manickavel, Sadir J. Alrawi
KEYWORDS:
Pouch of Douglas, Liposarcoma, Multidisciplinary Approach, Cytoreductive
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.6,
June
9,
2021
ABSTRACT: Introduction: This case report is one of a fairly common tumour in an
extremely uncommon anatomic location. Statistically liposarcoma is the
commonest type of soft issue malignancy, but publications of such a tumour
arising from the pouch of Douglas (POD) to involve the uterus, are very few and
far between. Case details: A 52-year-old woman presented with a mass in the
lower abdomen, post-menopausal vaginal bleeding, and lower abdominal discomfort.
Investigations revealed a large pelvic tumour that was attached to the
posterior wall of a bulky uterus. There was no evidence of dissemination of the
tumour to distant sites, and a laparotomy was performed. A massive soft tissue
tumour occupied the POD. The tumour was dissected out from the surrounding
structures, and the uterus and its appendages were removed in to. The
histopathological examination revealed a liposarcoma of the pleomorphic type
which was arising from the pouch of Douglas (POD),
and was attached to the posterior wall of the uterus. Extensive leiomyomatous
changes were seen in the uterus. Immunohistochemistry confirmed the liposarcoma
to be of pleomorphic type. Conclusion: This case report is being published for
its rarity and to illuminate the specific issues in the treatment of this
ubiquitous tumour in an unusual site. The involvement of a Multidisciplinary
Team (MDT) helps to choose the optimal combination of cytoreductive surgery,
chemotherapy, and radiation for a given case with a POD malignancy.