Primary serous adenocarcinoma of the retroperitoneum with a response to platinum-based chemotherapy: a case report

Primary Retroperitoneal Carcinomas: New Insights into Pathogenesis and Clinical Management in Comparison with Ovarian Carcinomas and Carcinoma of Unknown Primary

Primary retroperitoneal carcinomas are very rare tumors. Their pathogenesis remains unknown but may be associated with that of ovarian carcinomas, considering the similarity in morphology and gender preference. Although metaplasia of coelomic epithelium is the most widely accepted theory, the pathogenesis of retroperitoneal carcinomas may differ by histologic subtype, like ovarian carcinomas. Mucinous carcinoma, which develops in both women and men, may originate in both primordial germ cells and Walthard cell nests that may be derived from the fallopian tube. Serous carcinomas may be associated with endosalpingiosis, the presence of fallopian tube-like epithelium outside the fallopian tube, and a remnant Müllerian tract. Endometrioid and clear cell carcinomas appear to be associated with extraovarian endometriosis. Additionally, both carcinomas in the retroperitoneal lymph nodes may be metastatic diseases from endometrial and/or renal cell cancer that regress spontaneously (carcinoma of unknown primary). Retroperitoneal carcinomas are difficult to diagnose, as they have no characteristic symptoms and signs. Surgery is the cornerstone of treatment, but the necessity of chemotherapy may depend on histological subtype. Further studies are necessary, in particular studies on endosalpingiosis, as endosalpingiosis is a poorly understood condition, although it is associated with the development of both serous and mucinous carcinomas.

FDG PET/CT in Primary Retroperitoneal Serous Carcinoma

ABSTRACT

Primary retroperitoneal tumors are rare. Of these, primary retroperitoneal serous carcinoma is extremely rare, with only 15 cases having been reported. A 62-year-old woman presented with abdominal bloating. PET/CT demonstrated 2 tumors showing increased FDG uptake lateral and medial to the right common iliac vessels, without other abnormal uptake. A laparotomy revealed no ascites or abnormalities except a myomatous uterus in the peritoneal cavity. After surgical removal of these retroperitoneal tumors, the patient received adjuvant paclitaxel/carboplatin chemotherapy and remained well for 80 months. This case points to the significance of 18 F-FDG PET/CT in determining the nature of retroperitoneal tumors.

Added value of contrast-enhanced ultrasound (CEUS) in the diagnosis of primary retroperitoneal serous adenocarcinoma: a case report

BACKGROUND

Primary retroperitoneal serous adenocarcinoma (PRSA) is a rare malignant disease. Given the rarity of the disease, the imaging features of PRSA are unclear. Contrast-enhanced ultrasound (CEUS) also plays an important role in the evaluation of the differential diagnosis of retroperitoneal lesions.

CASE PRESENTATION

We report the case of a 62-year-old woman of with increased CA125 levels for 1 year who was referred to our hospital. After conducting contrast-enhanced computed tomography and magnetic resonance imaging, the mass was misdiagnosed as a chocolate cyst. After transvaginal ultrasound (TUS) combined with CEUS, cystadenocarcinoma was considered as the initial diagnosis. Pathology results confirmed PRSA as the final diagnosis.

CONCLUSIONS

CEUS features of PRSA are reported for the first time based on this case, potentially aiding in the differential diagnosis of this rare entity before surgery.

Primary retroperitoneal serous adenocarcinoma: A case report of rare malignancy with literature review

The primary retroperitoneal serous adenocarcinoma (PRSAC) is a rare malignant tumor of the retroperitoneum. It shares the same pathological and biological behavior with ovarian serous carcinoma. Most of the cases develop as peritoneal adenocarcinoma and rarely occur in the retroperitoneum. It is reported as serous surface papillary carcinoma of the peritoneum and extraovarian peritoneal serous papillary carcinoma. We present a case of PRSAC in a 60-year-old woman. Only 11 cases of PRSAC have been reported from 1983 to 2019. Histopathological features with immunohistochemical expressions are important to diagnose PRSAC. The outcome and survival mainly depend on the possibility of surgical resection. Molecular genetics of PRSAC should also be studied in relation with its ovarian counterpart.

Exceptional response to chemotherapy followed by concurrent radiotherapy and immunotherapy in a male with primary retroperitoneal serous Adenocarcinoma: a case report and literature review

Background

Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely uncommon malignancy exclusively reported in females. Due to the rarity of the disease, it is difficult to establish a standardized treatment.

Case presentation

We describe a unique case of PRSA in a 71-year-old male who presented with right-sided lower back pain and numbness. Magnetic resonance imaging identified a mass invading the adjacent psoas muscle and twelfth rib. Tissue biopsy confirmed poorly differentiated PRSA. Patient was initially treated with neoadjuvant carboplatin and paclitaxel chemotherapy regimen. This resulted in complete radiological resolution of the tumor. However, 12 weeks later, rapid recurrence was noted on follow-up CT scan. The patient was then treated with external radiotherapy with concurrent nivolumab, an anti-PD-1 antibody. The patient displayed a positive response to treatment with reduction in primary tumor and metastases and had a sustained disease control.

Conclusion

Treatment with radiotherapy in combination with anti-PD-1 antibody could be an effective modality of management for PRSA.

Electronic supplementary material

The online version of this article (10.1186/s12885-019-5934-4) contains supplementary material, which is available to authorized users.

Resection for Primary Retroperitoneal Serous Adenocarcinoma and Liver Metastasis

Primary retroperitoneal serous adenocarcinoma (PRSA) is a rare malignancy of which only seven cases have been reported in the literature. The clinical features and outcomes of PRSA are not well understood. We herein report a case of PRSA with liver metastasis in a 74-year-old woman who was treated with surgical excision. The tumor cells were positive for estrogen receptor, Wilms tumor 1, PAX8, p53, and cytokeratin AE1/AE3. The final diagnosis was PRSA and liver metastasis. The pathological features of PRSA resemble those of ovarian serous carcinoma, which suggests that a combination of surgical excision with adjuvant chemotherapy may be the best option.

Serous adenocarcinoma of retroperitoneum: a case report

Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely rare malignancy, with only seven cases having been previously reported. We report a case of PRSA in a 42-year-old woman treated with surgical resection and adjuvant chemotherapy. The histopathological findings of PRSA resemble those of ovarian serous carcinoma, which indicates that a combination of complete surgical resection with adjuvant chemotherapy may be the best treatment option for PRSA.

Uncommon primary pelvic retroperitoneal masses in adults: a pattern-based imaging approach

There is a broad spectrum of primary pelvic retroperitoneal masses in adults that demonstrate characteristic epidemiologic and histopathologic features and natural histories. These masses may be classified into five distinct subgroups using a pattern-based approach that takes anatomic distribution and certain imaging characteristics into account, allowing greater accuracy in their detection and characterization and helping to optimize patient management. The five groups are cystic (serous and mucinous epithelial neoplasms, pelvic lymphangioma, tailgut cyst, ancient schwannoma), vascular or hypervascular (solitary fibrous tumor, paraganglioma, pelvic arteriovenous malformation, Klippel-Trénaunay-Weber syndrome, extraintestinal GIST [gastrointestinal stromal tumor]), fat-containing (lipoma, liposarcoma, myelolipoma, presacral teratoma), calcified (calcified lymphocele, calcified rejected transplant kidney, rare sarcomas), and myxoid (schwannoma, plexiform neurofibroma, myxoma).Cross-sectional imaging modalities help differentiate the more common gynecologic neoplasms from more unusual masses. In particular, the tissue-specific multiplanar capability of high-resolution magnetic resonance imaging permits better tumor localization and internal characterization, thereby serving as a road map for surgery.

A case of primary retroperitoneal serous adenocarcinoma

Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely rare malignancy, of which only six cases have been reported in the literature. Here, we describe a PRSA in a 75-year-old woman treated with surgical excision and adjuvant chemotherapy. The pathological features of PRSA resemble those of ovarian serous carcinoma, which suggests that a combination of surgical excision with adjuvant chemotherapy may be the best option.

Serous adenocarcinoma of the retroperitoneum, as a type of multifocal müllerian carcinoma

Primary retroperitoneal serous adenocarcinoma is an extremely rare clinical entity, with only five cases previously reported. We describe a 66-year-old woman with serous adenocarcinoma arising from the retroperitoneum, adhesive to the ileocecum. On MRI, the tumor was 17 x 10 x 6 cm in size and monocystic. The tumor cells were positive for CA125, estrogen receptor, and Wilms tumor 1, and were differentiated from enterogenic cyst by the presence of cytokeratin 7 (+), and the absence of cytokeratin 20 (-). Simultaneously, uterine adnexal serous adenocarcinoma was detected. The volume of the retroperitoneal tumor was 14 times larger than that of the uterine adnexal tumor. We suggest the possibility that the retroperitoneal cancer arose as a primary cancer from rests of the müllerian epithelium synchronously with the uterine adnexal cancer. The patient had been taking conjugated estrogen for 10 years, suggesting that long-term estrogen stimulation may have contributed to the progression of the tumors.