Chylous ascites associated with retroperitoneal sarcoma: case report

Abstract

Introduction: Chylous ascites is the result of the leakage of lipid-rich lymph into the peritoneal cavity. It is an uncommon condition, with an incidence of 1 per 20,000 cases of ascites, including those of neoplastic origin. Despite its rarity, it carries a high mortality rate, especially when it is of neoplastic origin. Case Description: A 55-year-old man presented with progressive abdominal enlargement over the past two weeks, accompanied by gastric fullness, nausea, and vomiting. On examination, he had a distended abdomen, tympanic sounds, shifting dullness, positive fluid wave sign, and generalized tenderness. Paracentesis revealed chylous ascitic fluid, confirming the diagnosis. Abdominal CT scan identified a retroperitoneal tumor consistent with liposarcoma. After complications due to nosocomial infections (pneumonia and diarrhea), his condition deteriorated, and he passed away. Conclusion: This case highlights the complexity of chylous ascites associated with retroperitoneal liposarcoma. Despite the negative outcome, the case contributes to the understanding of this rare entity and emphasizes the importance of careful management. It is crucial to include rare conditions like retroperitoneal liposarcoma in the differential diagnosis of ascites due to its poor prognosis when detected late. Chylous ascites may be a sign of malignancy and requires a meticulous diagnostic and therapeutic approach.