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Giménez-Bachs JM, Villar-García M, Fernández-López A, Salinas-Sánchez AS. Large retroperitoneal mass during pregnancy. Actas Urol Esp 2024; 48:404-406. [PMID: 38185317 DOI: 10.1016/j.acuroe.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 01/09/2024]
Affiliation(s)
- J M Giménez-Bachs
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain.
| | - M Villar-García
- Servicio de Radiología, Complejo Hospitalario Universitario de Albacete, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - A Fernández-López
- Servicio de Radiología, Complejo Hospitalario Universitario de Albacete, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - A S Salinas-Sánchez
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
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Al Laham O, Adi A, Alaitouni A, Sharaf Aldeen R, Alshiekh A, Hamed H. An enormous benign primary retroperitoneal mucinous cystadenoma: a case report and literature review of a seldom seen abdominal pathology. Ann Med Surg (Lond) 2023; 85:5736-5741. [PMID: 37915663 PMCID: PMC10617834 DOI: 10.1097/ms9.0000000000001335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance Retroperitoneal neoplasia comprise less than 2% of all tumours. benign primary retroperitoneal mucinous cystadenoma (PRMC) is an extremely rare tumour. Their clinical course is overall silent unless the patient presents with a vague abdominal or pelvic pain, abdominal distention, or a palpable mass. Their aetiology remains theorized and since 1989, only 46 cases (excluding ours) worldwide were documented in the literature. The majority of cases were discovered in females but the overall tumour incidence rate is still undetermined due to its rarity. Well-timed recognition of this pathology permits the necessary curative surgical intervention to take place. Case presentation We hereby illustrate the rare case of a 23-year-old female who presented to the surgical clinic complaining solely of an unexplained gradual increase of the abdominal contour. Their presurgical radiological analysis yielded an intraabdominal large-sized well-demarcated retroperitoneal mass. Clinical discussion Thorough resection of the mass was accomplished via open surgery. The subsequent microscopic analysis of excised tumour yielded the diagnosis of primary retroperitoneal mucinous cystadenoma of benign nature. Conclusion Primary retroperitoneal mucinous cystadenoma is a seldom seen tumour. The scarcity of its occurrence is further highlighted by the published data. Based on their conclusive review of the available published English-based literature, ours is the 47th documented case of a benign PRMC and it is the first documented case from our country; Syria. The impact of these findings warrants raising awareness on the subject and considering PRMC as a differential diagnosis when presented with a similar case in the clinical practice.
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Affiliation(s)
- Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Amir Adi
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Radiology, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Aliaa Alaitouni
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Pathology, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Rahaf Sharaf Aldeen
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Ali Alshiekh
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Hamoud Hamed
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
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Geetha SD, Kavoussi L, Thomas R, Savant D. Primary Retroperitoneal Mucinous Cystadenocarcinoma: A Case Report. Cureus 2023; 15:e39983. [PMID: 37415996 PMCID: PMC10321359 DOI: 10.7759/cureus.39983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/08/2023] Open
Abstract
Mucinous neoplasms are commonly seen in the ovaries and pancreas. Their occurrence in the retroperitoneum is uncommon. We present a case of a retroperitoneal mucinous cystadenocarcinoma in a 54-year-old female who presented with right flank pain. Imaging demonstrated an 8.6 × 7.9 cm mass at the anterior surface of the lower pole of the right kidney, suspicious for renal cell carcinoma. Serum tumor markers carbohydrate antigen 19-9 (CA 19-9) and cancer embryonic antigen (CEA) were within normal limits, and cancer antigen 125 (CA 125) was elevated. Surgical resection of the mass was performed. Intraoperatively, the mass was noted to lie in the retroperitoneum, unattached to the kidney. On gross examination, a 10.0 × 7.0 × 7.0 cm unilocular cystic structure with red-brown mucoid material was present. The inner lining was mostly smooth with areas of excrescences, covering less than 5% of the surface area. Microscopic examination showed cystic areas lined by mucinous epithelium with an underlying ovarian-type stroma. Solid areas showed features of a borderline papillary mucinous tumor with invasive carcinoma. A diagnosis of mucinous cystadenocarcinoma was made. Their occurrence in the retroperitoneum is unusual. Although rare, this entity should always be considered in the differential diagnosis of retroperitoneal cystic lesions.
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Zhang J, Zeng Q, Kang J, Chen J, Luo G, Liang Y. Primary retroperitoneal mucinous cystic tumour of borderline malignancy mimicking kidney duplicate: cases report and literature review. BMC Urol 2023; 23:32. [PMID: 36871009 PMCID: PMC9985836 DOI: 10.1186/s12894-023-01191-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/19/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Primary retroperitoneal mucinous cystic tumours with borderline malignancy (PRMC-BM) are rare and difficult to diagnose preoperatively. We are the first to report two cases of PRMC-BM which mimic a duplex kidney and evaluate the outcomes of different surgical procedures. CASE PRESENTATION We describe two cases of retroperitoneal cystic tumours. Both were diagnosed with duplex kidney with hydronephrosis on computed tomography scan. The first patient underwent robot-assisted laparoscopic surgery and was found to have a retroperitoneal cystic tumour. The other patient underwent an ultrasound-guided puncture before surgery and was diagnosed with retroperitoneal lymphangioma. Retroperitoneal cystectomy was performed using an open transperitoneal procedure. The final pathologic diagnosis in both cases implies PRMC-BM. The open surgical approach was associated with a shorter operation time, less intraoperative blood loss, and protected cyst wall integrity by comparing the different surgical approaches. During follow-up, the patient in the first case had tumour recurrence six months post-surgery, and the other patient was healthy without recurrence or metastasis 12 months post-surgery. CONCLUSIONS Primary retroperitoneal mucinous cystic tumours with borderline malignancy can be enclosed within the kidney and misdiagnosed as other cystic diseases of the urinary system. Thus, an open surgical approach may be more suitable for this type of tumour.
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Affiliation(s)
- Junlong Zhang
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, 510080, China
| | - Qinsong Zeng
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, 510080, China
| | - Jihui Kang
- Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Junxing Chen
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, 510080, China
| | - Guiyuan Luo
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, 510080, China.
| | - Yueyou Liang
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, 510080, China.
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Tahmasebi F, Morje M, Jamall H, Polson A, Deo N. Primary Retroperitoneal Mucinous Tumours Diagnosed in Pregnancy: A Case Report and Literature Review. Int J Womens Health 2019; 11:649-653. [PMID: 31908544 PMCID: PMC6930008 DOI: 10.2147/ijwh.s176219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/06/2018] [Indexed: 11/23/2022] Open
Abstract
We present the case of a pregnant patient who was found to have a primary retroperitoneal mucinous tumour (PMRT). An abdominal mass measuring 11.5 × 9.8 × 8.8cm, initially thought to be of ovarian origin, was found incidentally on ultrasound in a 36-year-old patient at 20 weeks’ gestation. Tumour markers were normal. She underwent an elective Caesarean section at 34 weeks, but the uterus, fallopian tubes and ovaries were normal. The mass was found to be retroperitoneal. A clinical decision was made to avoid further surgical exploration at the time. Following further surgical planning, the patient underwent open resection of the retroperitoneal mass, 6 weeks after her Caesarean section. Histology confirmed a moderately differentiated adenocarcinoma suggestive of a primary retroperitoneal mucinous adenocarcinoma. A literature review following this identified five case reports of PMRT in pregnancy in the last decade. In all cases, the patients underwent tumour resection without adverse pregnancy outcomes. While our patient had an uncomplicated pregnancy, she developed a 2cm lesion suggestive of disease recurrence 15 months post-operatively. A plan was made for surgical resection. PMRT are rare, but can occur in pregnant patients and patients of childbearing age. Tumour resection should be carried out, but where there is no concrete evidence of tumour invasion, the uterus and ovaries should be spared to avoid infertility and menopause. We would recommend early tumour resection, given its potentially aggressive nature.
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Affiliation(s)
- Farshad Tahmasebi
- Obstetrics and Gynaecology, Whipps Cross University Hospital, London, UK
| | - Mridula Morje
- Obstetrics and Gynaecology, St Thomas' Hospital, London, UK
| | - Hina Jamall
- Obstetrics and Gynaecology, Whipps Cross University Hospital, London, UK
| | - Alexander Polson
- Cellular Pathology, Histopathology, St Thomas' Hospital, London, UK
| | - Nandia Deo
- Obstetrics and Gynaecology, Whipps Cross University Hospital, London, UK
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Chaves MM, Castro R, Mota-Vieira L, Carneiro V. A rare case of a primary retroperitoneal mucinous cystic tumour with borderline malignancy and literature review. BMJ Case Rep 2019; 12:12/9/e230708. [PMID: 31488447 DOI: 10.1136/bcr-2019-230708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary retroperitoneal mucinous cystic neoplasms (PRMCN) with borderline malignancy are exceptionally rare tumours with lack of pathognomonic clinical and imaging-specific features. Here, we report a case of PRMCN with borderline malignancy in a 62-year-old woman who presented with abdominal pain. Imaging studies revealed a well-defined cystic mass on the right flank in close relation with the cecum and caecal appendix, without other findings suggestive of malignancy. A possible diagnosis of an ovarian epithelial tumour was ruled out intraoperatively. After surgical excision, microscopic examination allowed the final diagnosis. As there is no evidence of disease during follow-up, complete tumour resection without cystic rupture appears to be the best therapeutic option. Thus, although rare, this tumour should be considered when imaging findings suggest an ovarian mucinous neoplasm in women with normal ovaries. An international registry for rare tumours and longer follow-ups may contribute for more consistent approach for managing these patients.
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Affiliation(s)
- Mariana M Chaves
- Radiology, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Azores, Portugal
| | - Rita Castro
- General Surgery, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Azores, Portugal
| | - Luisa Mota-Vieira
- Molecular Genetics and Pathology, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Azores, Portugal.,BioISI - Biosystems & Integrative Sciences Institute, Universidade de Lisboa Faculdade de Ciencias, Lisboa, Lisboa, Portugal
| | - Vítor Carneiro
- Pathology, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Azores, Portugal
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Pesapane F, Van Renterghem S, Patella F, De Visschere P, Villeirs G. A case report and a literature review of primary retroperitoneal mucinous cystadenoma: the importance of imaging in diagnosis and management. Future Oncol 2018; 14:2923-2931. [DOI: 10.2217/fon-2017-0649] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Primary retroperitoneal mucinous cystadenoma (PRMC) is an extremely rare tumor: its histogenesis and its biological behavior remain speculative. Since most retroperitoneal tumors are malignant, a preoperative diagnosis of benignity is essential and it can be reached through imaging examinations, allowing a conservative management approach. We describe the case of a 52-year-old woman with abdominal pain and a palpable mass. Computed tomography of the abdomen revealed a retroperitoneal cystic mass, which was resected successfully through laparoscopy and diagnosed as PRMC. Although there are no pathognomonic, clinical or radiological findings for PRMC, it should be included in the list of differential diagnoses and its imaging criteria of benignity should always be sought, with the aim to exclude malignant tumors.
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Affiliation(s)
- Filippo Pesapane
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milano, MI, Italy
| | - Sofie Van Renterghem
- Department of Pathology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - Francesca Patella
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milano, MI, Italy
| | - Pieter De Visschere
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - Geert Villeirs
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
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