Successful management of a patient with preoperative respiratory failure due to a solid giant retroperitoneal tumor: a case report

BACKGROUND: We report the successful preoperative management of respiratory failure in a patient with a solid giant retroperitoneal tumor with a hemodynamic monitoring system and nasal high-flow therapy (NHFT). CASE PRESENTATION: Twenty days before his scheduled resection of a giant retroperitoneal liposarcoma, a 64-year-old man presented with dyspnea. After admission to our intensive care unit, he received NHFT and hemodynamic therapy using a LiDCOrapid V3™ monitor (Masimo Japan, Tokyo). NHFT and intense diuresis improved his respiratory condition. The tumor resection was performed on the 5th day. He was discharged to the general ward with an oxygen nasal cannula on the second postoperative day. Although preoperative transthoracic echography showed mild aortic regurgitation and moderate mitral regurgitation, the degree of regurgitation had become trivial about 1-month post-surgery. CONCLUSIONS: A cause of preoperative respiratory failure associated with a giant retroperitoneal tumor might be not only diaphragmatic compression but also heart failure and excess fluid volume.