Primary retroperitoneal soft tissue neoplasms – a pictorial review with radiological-pathological correlation

Congress:

ECR 2023

Poster Number:

C-16829

Type:

Educational Exhibit

Keywords:

Oncology, Retroperitoneum, Veins / Vena cava, CT, MR, PET-CT, Diagnostic procedure, Staging, Surgery, Education and training, Multidisciplinary cancer care, Tissue characterisation

Authors:

J. L. VILLALOBOS FRANCO, D. J. Roa Melo, M. J. Sarda, D. García Ortega, C. H. S. Sánchez- Caro, I. Sollozo-Dupont, Y. Villaseñor

DOI:

10.26044/ecr2023/C-16829

DOI-Link:

https://dx.doi.org/10.26044/ecr2023/C-16829

Learning objectives

To analyze imaging characteristics of retroperitoneal tumors in several modalities with histopathological verification, and follow-up of the lesions. To identify the imaging findings that are most important for anatomic localization and preoperative characterization.

Background

The retroperitoneal space is one of the most difficult regions to evaluate due to the multiplicity of fascial layers, spaces and interfascial planes contained within it.Diagnostic imaging is the cornerstone of retroperitoneal tumors and is often challenging for radiologists (locating the lesion, determining the extent of invasion, characterizing the type of pathology). CT and MRI are the primary imaging modalities for the diagnosis and follow up of these lesions.We conducted a single-center, retrospective, observational study at the National Cancer institute of Mexico from January 2016...

Findings and procedure details

Retroperitoneal sarcomas (RPS) are a rare type of malignancy derived from primitive multipotential mesenchymal precursors. They represent <1% of all malignant tumors(1). Overall incidence is 0.3%–0.4% per 100000 of the population(2), with peak incidence in the 5th decade of life (3). They can grow very large before producing any symptoms or can also be incidental findings. The most frequent RPS in adults (>55years) are well differentiated liposarcoma(WDL), de-differentiated liposarcoma(DDL) (40%) and leiomyosarcoma(LMS) (27%). In younger age groups LMS becomes more common(4,5). In our sample of...

Conclusion

The radiologist plays an important role in establishing the diagnosis, defining the extension and anatomical relationship of retroperitoneal tumors, performing image-guided biopsy, staging the tumor, assessing the feasibility of curative surgery and to detect early recurrences. According to our experience, CT is the most useful and widely available imaging modality in staging, restaging and follow up of these tumors. This article briefly summarizes the key features of the most common RPS in the general population; in the same way, it warns us of potential problems...

Personal information and conflict of interest

J. L. VILLALOBOS FRANCO: Nothing to disclose D. J. Roa Melo: Nothing to disclose M. J. Sarda: Nothing to disclose D. García Ortega: Nothing to disclose C. H. S. Sánchez- Caro: Nothing to disclose I. S. Sollozo-Dupont: Nothing to disclose Y. Villaseñor: Nothing to disclose

References

Mack T, Purgina B. Updates in Pathology for Retroperitoneal Soft Tissue Sarcoma. Current Oncology [Internet]. 2022 Sep 7 [cited 2023 Feb 14];29(9):6400–18. Available from: https://www.mdpi.com/1718-7729/29/9/504 Mettlin C, Priore R, Rao U, Gamble D, Lane W, Murphy GP. Results of the national soft-tissue sarcoma registry. J Surg Oncol [Internet]. 1982 Apr [cited 2023 Feb 14];19(4):224–7. Available from: https://onlinelibrary.wiley.com/doi/10.1002/jso.2930190410 Francis IR. Retroperitoneal sarcomas. Cancer Imaging [Internet]. 2005 [cited 2023 Feb 14];5(1):89–94. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665230/ Bonvalot S, Gronchi A, Hohenberger P, Litiere S, Pollock RE, Raut CP, et...

Fig 1: Contrast-enhanced CT in axial acquisitions (A,B,C), coronal (D, E) and sagittal...

Fig 2: Control contrast-enhanced CT was performed 6 months after surgery on the...

Fig 3: De-differentiated liposarcoma - high grade pleomorphic sarcoma (inflammatory...

Fig 4: A 53-year-old woman who went to the doctor for diffuse abdominal pain and edema...

Fig 5: CT-guided percutaneous biopsy, performed on the patient in Figure 4....

Fig 6: Post-surgical contrast enhanced CT performed on the patient in Figure 4. 2...

Fig 7: A 44-year-old male who attended a private doctor for abdominal pain. In the...

Fig 8: Patient in figure 7. Post-surgical contrast enhanced CT at 10 months (A):...

Fig 9: Patient in Fig. 7. Chest CT acquired 14 months after resection of the recurrent...

Fig 10: Patient in Figure 7. CT acquired 16 months after resection of left lung...

Fig 11: A 62-year-old male with increased volume in the right inguinal region and...

Fig 12: A 62-year-old male with a history of abdominal pain and increased abdominal...