Liposarcoma is a rare type of malignant tumor. It occurs most commonly in the extremities (52%), retroperitoneum (19%) and inguinal region (12%), in patients between 40-60 years of age and has a 1:1 ratio between genders [1]. Retroperitoneal liposarcoma is usually asymptomatic because they grow slowly and silently and may not become symptomatic until they became very large. Patients with giant retroperitoneal liposarcoma (those over 20 kg) are considered at great risk of perioperative complications such as desaturation, massive blood loss, hypotension, cardiac arrhythmia [2]. We present a case of 66-year-old woman with giant retroperitoneal liposarcoma (diameter 56x52x20 cm3 and weight 32,9 kg), diagnosed before operation as large ventral hernia. She underwent resection surgery under general anesthesia and we managed anesthesia procedures using invasive monitoring (central venous pressure and arterial blood pressure) and placing epidural catheter without major perioperative complications. The giant retroperitoneal liposarcoma may increase abdominal pressure, may compress abdominal aorta and inferior vena cava, may compress the gastrointestinal tract leading anemia or malnutrition, the tumor may lift up the diaphragm and cause reduced respiratory compliance and respiratory distress [2]. Anesthetic management for patients with giant retroperitoneal liposarcoma must be focused on: perioperative use of invasive monitoring (ABP and CVP), adequate fluid management, avoidance of compression on abdominal aorta and inferior vena cava, maintenance of adequate venous return, prevention of pain, hypoxaemia, hypercarbia, acidosis and temperature control.

11 / Anesthetic management in the patient with giant retroperitoneal liposarcoma: a case report