{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:00:50Z","timestamp":1753891250062,"version":"3.41.2"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Liposarcoma, a rare malignancy accounting for 1% of all cancers, constitutes 9.8\u201316% of soft tissue sarcomas. The retroperitoneum and extremities are primary sites of occurrence. Retroperitoneal liposarcoma (RLS), originating in retroperitoneal adipose tissue near the kidneys and mesentery, represents 0.07\u20130.2% of all tumors. Giant RLS is uncommon, and its presentation via inguinal herniation is exceedingly rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>A 43-year-old male presented with progressive right inguinal swelling over one year, initially diagnosed as an irreducible inguinal hernia. Physical examination revealed a non-pulsatile, soft inguinal mass persisting in supine position. Due to the patient\u2019s abdominal obesity and atypical resilience of the mass, abdominal computed tomography (CT) was performed, identifying a large fatty lesion (25\u202f\u00d7\u202f22\u202f\u00d7\u202f32\u202fcm) in the right abdomen and pelvis with septations and dense areas. Exploratory laparotomy revealed a lobulated, encapsulated retroperitoneal tumor adherent to the right kidney, retroperitoneal vasculature, and left ureter, with a nodule extending into the inguinal canal. En bloc resection and hernia repair were performed. Histopathology confirmed well-differentiated liposarcoma (WDLS) with MDM2\/CDK4 overexpression and MDM2 amplification via fluorescence <jats:italic>in situ<\/jats:italic> hybridization (FISH). No recurrence was observed during follow-up (3\u201312\u202fmonths postoperatively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In obese patients with abdominal obesity and irreducible inguinal herniation lacking obstructive symptoms, retroperitoneal tumors should be considered. Imaging (CT\/MRI) and molecular testing (MDM2 FISH) are critical for differential diagnosis. Complete surgical excision with safe margins remains the cornerstone of management, followed by rigorous surveillance.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1499764","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T11:49:12Z","timestamp":1746186552000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pseudo-beer belly disguised and presenting as inguinal hernia swelling: a case of massive retroperitoneal liposarcoma"],"prefix":"10.3389","volume":"12","author":[{"given":"Junfeng","family":"Xie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kexing","family":"Xi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baolong","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangbiao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongquan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hefang","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s12957-020-02069-2","article-title":"Perioperative strategy and outcome in giant retroperitoneal dedifferentiated liposarcoma-results of a retrospective cohort study","volume":"18","author":"Bachmann","year":"2020","journal-title":"World J Surg Oncol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.eucr.2018.08.020","article-title":"Fatty tumors of the retroperitoneum: lipoma or well-differentiated liposarcoma. 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