Type:
Educational Exhibit
Keywords:
Performed at one institution, Observational, Retrospective, Cancer, Diagnostic procedure, Ultrasound, MR, CT, Paediatric, Oncology, Anatomy
Authors:
F. Sheikh, K. McHugh; London/UK
DOI:
10.26044/ecr2020/C-05453
Findings and procedure details
We present our single institution experience in the imaging of infantile retroperitoneal teratomas over the period between 2009-2019 during which time we encountered 11 such cases. All patients were investigated initially with US followed by cross-sectional imaging in the form of MR and/or CT to assess the anatomy.
The age of presentation ranged from birth to 10 months of age in our cohort. 7 patients were female and 4 were males. Patients presented with a rapidly enlarging abdominal mass and the first line imaging modality performed was ultrasound. This demonstrated a heterogenous abdominal mass with fluid, solid and calcific components in varying proportions. There was often significant displacement of normal anatomical structures. Fig 2, 3, 4.
To delineate the full extent of the mass and its relationship with the surrounding structures an MRI was performed in 9 out of 11 cases. This demonstrated the cystic and fatty components well although the calcific components were less appreciable. T2 SPACE imaging was found to be particularly helpful in delineating vascular anatomy.
Due to the degree of vascular distortion of major abdominal vessls, a contrast enhanced CT in the portal venous phase was also performed for surgical planning and to delineate vascular anatomy in 9 out of 11 cases. For central and right sided masses, there was often marked distortion of the infrahepatic IVC (fig 6). Encasement and compression of renal vessels was also a feature resulting in vascular compromise to the kidneys (Fig 1).