Retroperitoneal Spindle Cell Liposarcoma Presenting With Bowel Obstruction

Spindle cell liposarcoma is a variant with rare retroperitoneal involvement. A 64-year-old Hispanic woman presented with abdominal pain and leg swelling. Imaging showed multifocal retroperitoneal disease. Biopsy confirmed spindle cell liposarcoma with MDM2 amplification. She was lost to follow-up because of lack of insurance and returned 5 months later with disease progression and bowel obstruction from sigmoid encasement. The surgery department favored colostomy, but stenting was chosen to avoid delay. Stenting relieved symptoms, and she received doxorubicin and dacarbazine. In unresectable disease, malignant obstruction requires balancing operative risk and treatment delays. Stenting may provide palliation while facilitating therapy.