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A 70 year-old female presented with a 40 x 40 cm unresectable liposarcoma which showed progression during chemotherapy. After renewed evaluation, a radical resection was done. The second case concerns a 64 year-old male with a 19 x 15 cm liposarcoma in the upper abdomen. A radical tumour resection together with the pancreatic tail, the spleen and the transverse mesocolon/colon was carried out. Both patients recovered without complications, and remain disease-free at two years. Retroperitoneal sarcomas are notoriously "silent", and may grow to considerable size before diagnosis. The evaluation is difficult, and radical resection frequently demands multiorgan surgery. Management at a national "Sarcoma Unit" is essential for the prognosis.

A 61-year-old woman presented with a 16 cm retroperitoneal sarcoma, which demanded a multispecialist effort. There was adherence to the left ureter, the iliac vessels, the mesosigmoideum and the small intestine. After angiographic embolization, the tumor, sigmoid colon and left ureter were excised. Histology, immunohistology and electron microscopy gave the diagnosis pleomorphic sarcoma. The microscopic radicality was doubtful, but we abstained from adjuvant radiotherapy due to the large field and risk of toxicity. The patient remains disease-free after 24 months.

The combined imaging modality PET/CT is a possible superior tool for evaluation of gastro-intestinal stromal tumor treatment illustrated in a case of a 59-year-old woman responding to imatinib.