Paraganglioma lateroaórtico / Latero-aortic paraganglioma

RESUMEN El feocromocitoma es un tumor productor de catecolaminas que procede de las células cromafines del sistema nervioso simpático. El 80-85% se localiza en la médula suprarrenal y el 15-20% son de localización extra adrenal y se denominan paragangliomas (PG). Alrededor del 97 % son benignos y se curan mediante la extirpación quirúrgica, y el restante 3% son malignos, capaces de producir metástasis a distancia. Se presenta el caso de una mujer de 43 años, que consultó por hipertensión, cefalea y palpitaciones. Presentaba elevación de catecolaminas urinarias, y por resonancia magnética se diagnosticó una masa de 50 por 41 mm latero aórtica. Le fue efectuada su resección por vía laparoscópica, sin complicaciones, con desaparición de los síntomas.

ABSTRACT Pheochromocytomas are catecholamine-producing tumors arising from the chromaffin cells of the sympathetic nervous system. Between 80-85% occur in the adrenal medulla and 15-20% are extraadrenal and are called paragangliomas (PG). About 97% are benign and are solved by surgical resection, while the remaining 3% are malignant and may produce distant metastases. We report the case of 43-year-old female patient who consulted due to hypertension, headache and palpitations. She had elevated urine catecholamines and presented a 50 x 41 mm latero-aortic mass on magnetic resonance imaging. The patient underwent laparoscopic resection of the tumor without complications and experienced relief of symptoms.

Biopsia ganglionar retroperitoneal por laparoscopia

Introducción: La biopsia ganglionar retroperitoneal es un procedimiento frecuentemente requerido en el estudio de neoplasias; resulta deseable optimizar su rendimiento con baja morbilidad. Este artículo describe la utilidad y complicaciones de biopsias ganglionares retroperitoneales por laparoscopia en una institución oncológica de Latinoamérica. Material y Métodos: Cohorte retrospectiva de pacientes con biopsia ganglionar retroperitoneal o mesentérica laparoscópica entre 2011 y 2021 en el Instituto Nacional de Cancerología, en Bogotá, Colombia. Se recogieron datos demográficos, quirúrgicos, complicaciones y mortalidad a 30 días, resultados histopatológicos y su rol en la clínica. Resultados: Se incluyeron 41 pacientes; 73% con diagnóstico de malignidad, principalmente linfoma. La indicación fue mayormente sospecha de recaída, seguida por sospecha de enfermedad hematológica de novo. Siempre se obtuvo tejido adecuado y suficiente para diagnóstico histológico. Requirieron conversión a laparotomía cinco pacientes (12%). No hubo complicaciones Clavien-Dindo III /IV ni mortalidad a 30 días. Se presentó morbilidad grado I o II en 3 casos (7%) y un incidente intraoperatorio grado III. Conclusión: La naturaleza invasiva y el carácter diagnóstico de la biopsia retroperitoneal laparoscópica, constituyen un desafío frecuente en la práctica del cirujano general. La planeación estratégica e individualizada y la técnica quirúrgica depurada son las claves para lograr el máximo rendimiento, con baja morbimortalidad.

Introduction: Retroperitoneal lymph node biopsy is a frequently required procedure in the study of neoplasms; it is desirable to optimize its performance with low morbidity. This paper describes the usefulness and complications of retroperitoneal lymph node biopsies by laparoscopy in a cancer institution in Latin America. Material and Methods: Retrospective cohort of patients with laparoscopic retroperitoneal or mesenteric lymph node biopsy between 2011 and 2021 at the National Cancer Institute, in Bogotá, Colombia. Demographic and surgical data, complications and 30-day mortality, histopathological results and their clinical role were collected. Results: 41 patients were included; 73% diagnosed with malignancy, mainly lymphoma. The indication was mostly suspected relapse, followed by suspected de novo hematologic disease. Adequate and sufficient tissue was always obtained for histological diagnosis. Five patients (12%) required conversion to laparotomy. There were no Clavien-Dindo III/IV complications or 30-day mortality. Grade I or II morbidity occurred in 3 cases (7%) and a grade III intraoperative incident. Conclusion: The invasive nature and diagnostic character of laparoscopic retroperitoneal biopsy constitute a frequent challenge in the practice of the general surgeon. Strategic and individualized planning and a refined surgical technique are the keys to achieving maximum performance, with low morbidity and mortality.

MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy. To date, 51 cases have been reported, including 3 in pregnant women. Herein, we report magnetic resonance findings of a 31-year-old Korean woman (15 weeks and 3 days pregnant) with primary retroperitoneal mucinous cystadenocarcinoma. On abdominal magnetic resonance imaging (MRI), a mass was identified in the retroperitoneal area with a nodular lesion showing heterogeneous signal intensity and focal wall thickening on T1- and T2-weighted images. Exploratory laparotomy and tumor excision were performed. Histological examination revealed primary retroperitoneal mucinous cystadenocarcinoma. The patient subsequently underwent total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy for metastatic mucinous cystadenocarcinoma of both ovaries 15 months after her initial surgery.

Retroperitoneal Bronchogenic Cyst: A case report / 대한흉부외과학회지

Bronchogenic cysts are usually located in the pulmonary parenchyma or in the mediastinum. When bronchogenic cysts are located in the mediastinum, they are usually near the bronchus or esophagus, and rarely located in the retroperitoneal space. It is difficult to differentiate between bronchogenic cysts and benign cysts prior to surgert. We report here on a patient for who had a mass in the retroperitoneum, with the preoperative diagnosis being a benign neurogenic tumor. Via left open thoracotomy, pathologic reports revealed that the mass was a bronchogenic cyst. We report here on the case of a bronchogenic cyst that was located in the retroperitoneal space of the diaphragm.

A Case of Acute Kidney Injury due to Retroperitoneal Sarcoma / 대한신장학회지

Retroperitoneal sarcoma is a rare tumor accounting for 1-2% of all solid malignancies. These tumors are usually large when diagnosed because of their typically silent nature and should be distinguished from other retroperitoneal masses for adequate management. In spite of an apparent complete resection which is the only potential curative treatment, the high rate of local recurrence is the major problem of retroperitoneal sarcoma; therefore, patients with high-grade tumors should undergo regular and continuous follow-ups. Postrenal acute kidney injury (AKI) results from a urinary outflow tract compression due to the mass effect of retroperitoneal sarcoma, which is one of less common causes of postrenal AKI and has not been reported in Korea. We report a case that an 81-year-old-woman with undifferentiated retroperitoneal sarcoma presented with postrenal AKI and improved after complete resection.

Retroperitoneal Pulmonary Sequestration in a Neonate : A case report / 대한흉부외과학회지

Retroperitoneal pulmonary sequestration is an extremely rare congenital malformation. It is more frequently diagnosed in the antenatal period due to routine ultrasonic examinations that are conducted for a fetus or during the first 6 months of life, although retroperitoneal pulmonary sequestration is incidentally discovered in adults on rare occasions. Because the location and radiological findings of retroperitoneal pulmonary sequestration are very similar to those of another retroperitoneal masses, retroperitoneal pulmonary sequestration, although they are very rare, should be included in the differential diagnosis of a retroperitoneal suprarenal mass. Although fine needle aspiration may be considered as an aid for making the preoperative diagnosis, surgery remains the treatment of choice for symptomatic lesions and this surgery is associated with excellent results and a good prognosis.

A Case of Retroperitoneal Liposarcoma in Continuous Ambulatory Peritoneal Dialysis Patient / 대한신장학회잡지

Liposarcoma accounts for at least 20% of all soft tissue sarcoma in adults and occur anywhere in the body, although about 14% of cases arise from retroperitoneum. Liposarcoma usually presents as a painless, enlarging mass that can slowly grow over many years. We here report a case of retroperitoneal liposarcoma in a 52 years old female patient undergoing continuous ambulatory peritoneal dialysis. Retroperitoneal liposarcoma was incidentally found by computed tomography which was performed due to ventral hernia and confirmed by ultrasonography guided-biopsy. She was treated successfully by wide surgical resection and transferred to hemodialysis.

Solitary Paraaortic Lymph Node Metastasis of Primary Hepatocellular Carcinoma which was Misdiagnosed as Primary Retroperitoneal Tumor

The prognosis of primary hepatocellular carcinoma is very poor, and a curative resection is capable only in few selected patients. Most patients die from tumor recurrence. The rate of intrahepatic recurrence of hepatocellular carcinoma is much higher than extrahepatic recurrence or metastasis. The most common site of extrahepatic metastasis is lung, and followed by lymph nodes, bone and adrenal gland. Common sites of node metastasis are celiac lymph nodes and hepatoduodenal lymph nodes, however paraaortic lymph node metastasis is very rare. Here, we report an experience of solitary paraaortic lymph node metastasis from hepatocellular carcinoma which was misdiagnosed as primary retroperitoneal tumor by preoperative imaging studies.

A case of Huge Isolated Retroperitoneal Leiomyoma / 대한산부인과학회지

Primary retroperitoneal neoplasms are rare, accounting for only 0.1-0.2% of all malignancies. Retroperitoneal location of leiomyoma are uncommon. Less than 2% of retroperitoneal tumors are leiomyomas. We report a case of huge retroperitonal leiomyoma mimicking solid adnexal mass with brief literature review.

A Case of Primary Retroperitoneal Synovial Sarcoma

A retroperitoneal Synovial Sarcoma is defined as a tumor arising in the retroperitoneal space, with an origin of mesodermal structures. The majority of synovial sarcomas (85 to 95%) occur in the extremities, located near the large joints. They are uncommon, and usually appear as a non- specific soft tissue mass, with no specific imaging feature. However, in some cases, radiological findings and anatomic location of the tumor may help the diagnosis. On CT examination, these tumors may be shown as hypo-dense masses and have an irregular enhancement in the periphery, with a poor enhancement in the central area, reflecting the necrotic, cystic and hemorrhagic changes. Histologically, there are two types of synovial sarcoma: biphasic and monophasic. Both types have about a 40% mortality rate. The known prognostic factors are; frequent mitotic figures, extensive tumor necrosis, and poor differentiation. Surgical ablation remains the mainstay of their management. Regardless of adequate surgical and adjunctive therapies, the recurrence rate ranges from 28 to 36%. Here, we present a case of a retroperitoneal synovial sarcoma, with a review of the literature.

Hyaline-vascular Variant of Castleman's Disease in Retroperitoneum / 대한비뇨기과학회지

Castleman's disease is characterized by a massive growth of lymphoid tissue. Since first report in 1956, multiple terms have been used to describe Castleman's disease, including lymph nodal harmatoma, angiofollicullar lymph node hyperplasia, benign giant lymphoma and giant lymph node hyperplasia. Castleman's disease is rare and poor by understood and the optimal therapy is unknown. There are two basic pathologic types in Castleman's disease: Hyaline-vascular type and plasma cell type. Hyaline- vascular type tends to be asymptomatic and is more common in the localized form. Here we report a case of hyaline-vascular type Castleman's disease in retroperitoneum and review previous reports.

The prevention and management of massive bleeding during resection of retroperitoneal tumour / 中国普通外科杂志

Objective To improve the safety and decrease the blood loss during resection of retroperitoneal tumour (RRT).[WT5”HZ]Method [WT5”BZ]We analysed retrospectively 54 patients whose blood loss were over 3?000?ml during RRT in our hospital from 1983 to 1998.The blood loss was over 5?000?ml each in 22 patients,and over 8?000?ml each in 7 patients, the maximum blood loss was 10?000?ml.[WT5”HZ]Result [WT5”BZ]Among the 54 patients whose blood loss were over 3?000?ml and up during RRT, 17 sank into shock and 2 of them died.[WT5”HZ]Conclusion [WT5”BZ]The preoperative evaluation and preparation are important to operative safety.We emphasize intraoperative management of massive bleeding during RRT.