Leiomyosarcoma of the Ovarian Vein: a Case Report with Radiological Findings

Leiomyosarcomas of the ovarian vein are very rare. Four cases have been reported in the English language clinical literature. We present a case of leiomyosarcomas where the use of multi-detector CT had a substantial role in the establishment of the preoperative diagnosis. The radiological images as well as intraoperative features are illustrated. We also discuss the radiological findings of the ovarian vein leiomyosarcoma in comparison with those of other venous or retroperitoneal leiomyosarcomas. We expect that the use of multi-detector CT will be the choice for the diagnostic work-up of vascular leiomyosarcomas.

A Retroperitoneal Foregut Duplication Cyst: A Case Report

Retroperitoneal foregut duplication cyst is an extremely rare congenital malformation. Pathologically, this lesion contains both gastric mucosa and respiratory type mucosa; radiologically, it is often challenging to differentiate it from the other cystic neoplasms that present a similar appearance. We report here on a case of retroperitoneal foregut duplication cyst that was lined by both gastric and pseudostratified ciliated columnar epithelium, and it was also accompanied by a pancreatic pseudocyst. Initially, it presented with peripancreatic and intrapancreatic cystic masses in an asymptomatic 30-year-old man, and this man has since undergone surgical resection.

Imaging Findings of Retroperitoneal Ganglioneuroma

PURPOSE: To characterize the typical radiologic appearance of ganglioneuromas of the adrenal gland and extra-adrenal retroperitoneum. MATERIALS AND METHODS: The findings of diagnostic imaging studies (CT, n=5; ultrasound, n=1) involving six patients aged 19-58 years with pathologically proven ganglioneuroma were retrospectively analyzed by three radiologist in terms of the lesions' size, shape, margin, location, CT attenuation (unenhanced/contrast-enhanced), necrosis, calcification, relationship with adjacent vessels, and US echogenicity. RESULTS: The maximum diameter of the six tumors ranged from 10 to 14 (mean, 11.3) cm, and the margin was well-defined in all cases. The homogeneous or slightly heterogeneous attenuation demonstrated at unenhanced CT was less than that of muscle. Dense nodular calcification was present in one case. At contrast-enhanced CT, enhancement was poor (n=5), mild and septum-like, or delayed, heterogeneous and focal (n=3), or involved subtle foci (n=1). In no case was there evidence of necrosis or hemorrhage. Local invasion was absent, but adjacent vascular encasement (n=2) or displacement (n=2) occurred. Ultrasonic examination demonstrated low echogenicity and mild heterogeneity (n=1). CONCLUSION: A ganglioneuroma is an uncommon benign neural crest tumor which should be included in the differential diagnosis of a retroperitoneal mass which presents as a well-defined tumor, tend to encase or displace adjacent major blood vessels, and shows low attenuation at unenhanced CT and poor or septum-like focal enhancement at contrast-enhanced CT.

Angiomyolipoma of the Perinephric Space: Case Report

Angiomyolipomas commonly originate from renal parenchyma but extremely rarely from perinephric space. We report a case of angiomyolipoma of the perinephric space confirmed by radical nephrectomy. A 13-year-old boy presented with left flank pain and abdominal distension, first experienced five months earlier. Ultrasonography and CT indicated that in the space surrounding the left kidney, a huge fat-containing mass with linear strands was present.

A Solitary Fibrous Tumor of the Retroperitoneum: CT Findings

The solitary fibrous tumor is a rare spindle cell neoplasm of mesodermal orgin. It usually arises in thepleura, though has recently been reported in the peritoneum, and at nonserosal sites; it is, however, extremelyrare in the retroperitonum. The authors describe one case of a solitary fibrous tumor occurred as a huge complexmass in the retroperitoneum of an adult. Preenhanced CT scans showed that the mass was sharply delineated fromsurrounding organs and that tumor density was the same as that of surrounding musculature. PeripheralCalcifications were noted, and postenhanced scans showed intense, gradual enhancement of solid portions of themass, with nonenhanced cystic portions. Although not specific, solitary fibrous tumors must be included in the differential diagnosis of a large retroperitoneal tumor of complex consistency and with internal calcification.

Radiologic Findings of Malignant Retroperitoneal Fibrosis

PURPOSE: To evaluate the radioloic findings of malignant retroperitoneal fibrosis. MATERIALS AND METHODS: Post-contrast CT (n=9) and urographic (n=7) findings of nine patients with malignant retroperitoneal fibrosis were retrospectively analyzed. Primary tumors were found to be advanced gastric cancer (n=6), early gastric cancer (n=1), breast cancer (n=1), and cervical cancer (n=1). We analyzed CT findings with regard to the site of soft tissue lesion, ureteral involvement, the presence or absence of hydronephrosis, and distant metastasis. The level and length of ureteral involvement, presence or abscence of ureteral stenosis, and ureteral displacement as seen on urography, were analyzed. RESULTS: On CT scans, enhanced soft tissue lesions (mass, 5 cases; plaque, 4 cases) encircling the abdominal aorta and IVC were noted in all cases. Thickening of the ureteral wall (n=8), hydronephrosis (n=9), and enlarged lymph node (n=5) were also seen. On urography, irregular stenosis and medial displacement of ureters from level L2 to S2 were noted in all cases. The length of ureteral involvement was 4-6.5cm. CONCLUSION: The common CT findings of malignant retroperitoneal fibrosis were enhanced soft tissue lesion encircling the abdominal aorta and IVC, hydronephrosis, and thickening of the ureteral wall. On urography, ureteral stenosis and medial displacement were seen.

Benign Lipoblastoma in Retroperitoneum: A Case Report

We report a case of histopathologically confirmed benign lipoblastoma in the retroperitoneum. The tumor presented itself as an ill-defined low density mass on a simple radiograph, as a highly heterogeneous echogenicmass on US, and fatty density mass separated by unenhanced linear septa of soft tissue density on CT. The well circumscribed and encapsulated tumor was totally removed by operation. CT is considered the modality of choice for characterizing lipoblastoma and demonstrating its location and boundary. When there is fatty density mass in there troperitoneum of a children, the possibility of lipoblastoma should be considered first.

Solitary Fibrous Tumor in Retroperitoneum

The solitary fibrous tumor, of rare mesodermal origins, primarily affects the pleura and occasionally occursin the peritoneum and at nonserosal sites. Although this is a pathologically well established entity, it isfrequently confused radiologically and pathologically with other tumors of mesenchymal origin. We report one case of a solitary fibrous tumor in the retroperitoneum. The 15X10X7cm mass, lacated in the left perirenal space just above the left kidney, had relatively homogeneous consistency and was well-delineated from surrounding organs inCT and MR images. It showed intense, gradual, centripetal enhancement during dynamic scans, and partially unenhanced areas which matched the high signal intensity portions in T2 weighted MR images, pathologically correlated to myxoid degeneration. Although not specific, when a large, well-delineated mass of strong contrast enhancement with lack of massive necrosis is encountered, solitary fibrous tumor must be included in the differential diagnosis of a refroperitoneal soft tissue mass.