A retroperitoneal myopericytoma: The first case located at the retroperitoneal area and not originate from the kidneys

A 25-year-old woman had a mass of approximately 65 cm × 33 cm × 102 cm, located in the left paraaortic area on CT scan. It was diagnosed as retroperitoneal malignant neoplasm on imaging. Afterward, open retroperitoneal tumor excision was performed. At laparotomy, the mass was carefully dissected from the ureter, renal artery, and aorta and excised as en-bloc. The pathological result was “myopericytoma.” Histologically, the pathological findings characterized a pericytic neoplasm characterized by a perivascular growth of myoid tumor cells. In addition, there were uniform, oval-shaped cells with eosinophilic cytoplasm arranged in short fascicles around blood vessels. The cytologic atypia and mitoses were absent. There are many different tumors in the retroperitoneal area. Most of these lesions are malign nature. Nevertheless, for each benign and malign neoplasm, the preoperative imaging method is generally similar. This present case showed the significant findings of myopericytoma, a benign pathology located in the retroperitoneal area.

Leiomioma parasitario retroperitoneal: reporte de un caso / Retroperitoneal parasitic leiomioma: A case report

Resumen ANTECEDENTES: Los leiomiomas parasitarios son una variante poco común de la miomatosis uterina. Se han identificado en la pared abdominal, intestino delgado, muñón cervical o vaginal, vasos iliacos, ovarios, colon sigmoides y en el omento mayor. OBJETIVO: Reportar un caso clínico de leiomioma parasitario retroperitoneal y revisar la bibliografía al respecto. CASO CLÍNICO: Paciente de 57 años, con diagnóstico de NIC-III y hemorragia uterina anormal. Acudió a consulta debido a una sensación de masa y dolor abdominal, pérdida de peso subjetiva, hiporexia, disfagia y plenitud gástrica de cuatro meses de evolución. En los estudios de extensión se documentó una masa retroperitoneal grande y elevación de los marcadores tumorales Ca 125 y Ca 19-9. La resección de la masa se efectuó mediante laparotomía, con hallazgo histopatológico de mioma parasitario. CONCLUSIÓN: Los leiomiomas parasitarios deben considerarse en el diagnóstico diferencial de pacientes con antecedente de histerectomía o miomectomía, sobre todo en el contexto de la morcelación. El tratamiento consiste en cirugía o inhibidores de la aromatasa y análogos de la hormona liberadora de gonadotropina (leiomiomatosis peritoneal diseminada).

Abstract BACKGORUND: Parasitic leiomyomas are a rare entity, defined as an unusual variant of uterine myomatosis. Have been documented in the abdominal wall, small intestine, cervical or vaginal stump, iliac vessels, ovaries, sigmoid colon, and greater omentum. OBJECTIVE: To report a clinical case of retroperitoneal parasitic leiomyoma and review the literature. CLINICAL CASE: A 57-year-old patient with a diagnosis of CIN-III and secondary abnormal uterine bleeding, who consulted for a sensation of abdominal mass and pain, subjective weight loss, hyporexia, dysphagia and gastric fullness, of four months of evolution. Extension studies document a large retroperitoneal mass and elevation of tumor markers Ca 125 and Ca 19-9. We practice surgical management of her gynecological pathology and resection of the mass by laparotomy, with histopathological finding of myoma. CONCLUSION: Parasitic leiomyomas should be suspected in patients with a detected mass and a history of hysterectomy or myomectomy, especially in the context of morcellation. The treatment of this condition is surgical and, in cases of disseminated peritoneal leiomyomatosis, pharmacological treatments have been used with aromatase inhibitors and gonadotropin-release hormone analogues.

Role of computed tomography scan in diagnosis of retroperitoneal masses

Background: In the vast and ever-expanding field of surgery there are only few subjects which have provoked controversy; curiosity related to correct management of patients suffering from various condition of the abdomen. This becomes very true when the patient has a retroperitoneal mass clinically. The problem of retroperitoneal mass was intriguing, fascinating and certainly most perplexing. The present study was planned with the objective to study the various clinical presentations of retroperitoneal mass, and their radiological findings, and co-relation between these various findings.Methods: This was a prospective, cross-sectional study. The study included 30 patients clinically diagnosed having retroperitoneal mass, attending the department of general surgery.Results: The most common affected age group was of 40-50 years (9, 30.00%). The most frequent presenting symptoms were abdominal lump (28, 93.33%). Pallor was the commonest clinical sign (20, 66.67%). Retroperitoneal lymph node masses were the commonest (12, 40.00%) malignant lesions. Retroperitoneal lymphadenopathy was the most common lesion.Conclusions: The retroperitoneum has long been an area poorly visualised by conventional radiographic techniques and in this respect, computed tomography scan has great advantages over other modalities. Hence the modern surgeon should no longer be considered a ‘shadow-gazer' but an anatomist in-vivo.

Burned-Out Testicular Choriocarcinoma with Retroperitoneal and Liver Metastases

Spontaneous regression or the ‘burned-out’ phenomenon of testicular germ cell tumors is well-recognized but a rare clinical entity of which few reports exist. Tumors with the ‘burned-out’ phenomenon are found in metastatic sites, not in the testis. We report a 33-year-old patient who presented with liver choriocarcinoma and a retroperitoneal mass with the ‘burned-out’ phenomenon in the testis.

Hypertensive Crisis during Removal of Retroperitoneal Mass in a Patient with Undiagnosed Paraganglioma - A Case Report - / 대한구급학회지

Paragangliomas have been reported on multiple locations. A diagnosis of a catecholamine-secreting tumor was considered only after induction of anesthesia, when BP (blood pressure) increased. A 61-year-old male patient was referred for removal of a retroperitoneal mass suspected hemangiopericytoma. He was on medications for hypertension. There was a surge of ABP (arterial blood pressure) to 186/117 mmHg when the tumor was manipulated at the beginning of the surgery, and this was treated by bolus of diltiazem. After resection of the tumor, ABP dropped to 57/36 mmHg. In order to improve the patient's hemodynamic parameters, crystalloid fluid was given, and ephedrine was administered intravenously. Persistent hypotension was treated with titrated vasopressors (epinephrine and norepinephrine). When paraganglioma is suspected due to a sudden hypertensive crisis during surgery, the surgeon must decide whether to proceed with the surgical procedure or to stop and restart the surgery after proper management of the crisis.

Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.

Pulmonary and retroperitoneal benign metastasizing leiomyoma / 대한생식의학회지

Benign metastasizing leiomyoma (BML) is a rare disease, which usually occurs in women with a history of a prior hysterectomy or myomectomy for benign uterine leiomyoma, and has the potential to metastasize to distant sites, such as the lung, lymph nodes, muscular tissue, heart, or retroperitoneum. These lesions are slow-growing, asymptomatic, and usually found incidentally. The prognosis of BML is also excellent. However, there has been debate on the origin and the correct classification of BML, and there are no guidelines for the treatment of BML. We report here on a rare case of BML in both the retroperitoneal cavity and lung in a 48-year-old woman with a history of hysterectomy due to histologically benign uterine leiomyoma. The patient underwent retroperitoneal mass excision and bilateral salpingo-oophorectomy, and then wedge biopsy of two pulmonary nodules was performed additionally 9 days later. Until now, there has been no sign of recurrence and the patient remains asymptomatic. To our knowledge, pulmonary BML is rare and the co-existence of the retroperitoneal metastases after previous hysterectomy is even rarer.

Retroperitoneal Lymphangioleiomyomatosis without Pulmonary Feature

Lymphangioleiomyomatosis (LAM) is discovered mainly in the pulmonary area, and the typical presenting symptoms include progressive dyspnea, pneumothorax, and chylous pleural effusion. An initial presentation of LAM with extrapulmonary symptoms is extremely rare. Most reports and reviews have concentrated on the pulmonary symptoms and radiological image of LAM. Some of reports focused on the abdominal abnormalities or retroperitoneal abnormalities in addition to pulmonary features. However, LAM without pulmonary features is extremely rare. We encountered a 36-year-old woman with a retroperitoneal mass measuring 7 cm in the anterior aspect of the right adrenal gland. The patient did not have any pulmonary symptoms or radiological abnormalities, and underwent a laparoscopic excision. The tumor was diagnosed histologically as a lymphangioleiomyomatosis. LAM without pulmonary feature is unusual case. We report this case with a review of the relevant literature.

A case of retroperitoneal huge smooth muscle tumor misleading to ovarian cancer / 부인종양

Smooth muscle tumors are very common tumors in the uterus and related adjacent structures but occur rarely in the retroperitoneum. Traditionally, most retroperitoneal smooth muscle tumor are believed to be malignant. But well-differentiated smooth muscle tumors with lack of atypia, necrosis, and significant mitotic activity appear to have a benign behaviors. Laparotomy revealed a huge solid tumor in the retroperitoneal space, about 50 cm in diameter, and histologically diagnosed as a smooth muscle tumor of uncertain malignant potential (STUMP). We report a case of primary retroperitoneal smooth muscle tumor with a brief review of literatures.

El caso de infecciosas: malacoplaquia renal, duodenal y retroperitoneal: presentacion de un caso y revision del tema / The case of infectious diseases: renal malakoplakia, duodenal and retroperitoneal: a case report and review of the topic

Se presenta el caso de una mujer de 52 años, residente en Medellín, quien consultó al Hospital Pablo Tobón Uribe con historia de Diabetes Mellitus y 2 meses de evolución de fiebre, escalofríos, disminución de peso y presencia de masa retroperitoneal, con compromiso de riñón derecho y duodeno. El diagnóstico de malacoplaquia fue hecho por biopsia y confirmado en el Instituto de Patología de las Fuerzas Armadas de Washington. Este caso corresponde al tercero colombiano y el primero de esta localización. El paciente recibió tratamiento con ciprofloxacina y 2 años después continúa en buenas condiciones de salud.

Here we present a case ofa 52 year oldwoman resident in Medellín, Colombia, who carne for a check up to the Hospital Pablo Tobon Uribe with a history ofDiabetes Mellitus and with two-month symptoms offever, chills, weight loss, and a retroperitoneal mass along with a compromise ofa right kidney and duodenum. The diagnosis of Malacoplakia was done with a biopsy and confirmed at the Pathology Institute of the Armed Forces in Washington.This is the third case diagnosed in Colombia and the frrst one located in this site. The patient received treattnent with ciprofloxacine and two years after treattnent she still in good health conditions.

A Case of Retroperitoneal Castleman`s Disease / 대한비뇨기과학회지

We report a case of Castleman`s disease of the hyaline-vascular type which was located in retroperitoneum. A 20-year-old girl was admitted because of a history of postprandial epigastric discomfort. Computed tomography of the abdomen demonstrated a solid 7 x 7 cm mass between the abdominal aorta and the left kidney in the retroperitoneum. At surgery, a solid 9 x 8 x 6 cm tumor was resected. Pathologic diagnosis was Castleman`s disease of the hyaline-vascular type.

A Case of Retroperitoneal Castleman's Disease / 대한비뇨기과학회지

Castleman's disease (angiofollicular lymph node hyperplasia) is a large benign tumor. Most of the lesion are located in mediastinum, but some presents as an isolated retroperitoneal mass radiographically indistinguishable from retroperitoneal malignancy. We report a case of the hyaline-vascular variant of Castleman's disease presenting as a palpable abdominal mass.