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Case Reports
. 2008 Jul-Sep;1(3):334-42.

The management of primitive retroperitoneal tumors--problems of clinical, imaging diagnosis, and treatment

Bratu Ovidiu  1 , Madan Victor, Rusu Florin, Ilie Cristian, Mischianu Dan, Barla Rodica, Hoara Petre, Constantinoiu Silviu
Affiliations
Case Reports

The management of primitive retroperitoneal tumors--problems of clinical, imaging diagnosis, and treatment

Bratu Ovidiu et al. J Med Life. 2008 Jul-Sep.

Abstract

Retroperitoneal tumors, whether primary or resulting from the metastasis of other tumors, are a real challenge for the surgeon, in terms of their diagnosis and treatment. They are relatively rare, under 0.2% of the total number of tumors. The clinical examination of retroperitoneal tumors is uncharacteristic and misleading, consisting mainly in palpation of the tumor proper and in assessment of pain. The other signs and symptoms often result from the affected neighboring organs. The imaging investigations used in diagnosing retroperitoneal tumors are ecography, intravenous pyelography, computed tomography, MRI, PET/CT. The main treatment is surgical, consisting either in total or partial excision of the tumor, or in biopsy samples to make a histopathologic diagnosis. Post-operative course depends mainly on the thoroughness of the surgical treatment, that is the complete excision of the tumor, which increases the chances of survival, while lowering the risk of relapse.

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Figures

Fig.1,2
Fig.1,2
MRI images – invading retroperitoneal tumoral formation in vertebrae L4,L5
Fig.3
Fig.3
L.V.P. Left ureterohydronephrosis, II-III degree, caused by tumoral compression on the lower lombar ureter.
Fig.4
Fig.4
The retroperitoneal tumor in relation to the lower cave vein
Fig.5,6
Fig.5,6
Post-surgery images of the excised piece
Fig.7
Fig.7
The retroperitoneal (pelvisubperitoneal) tumor and its relation to the pelvic organs
Fig.8
Fig.8
Isolating the pelvic ureter from the retroperitoneal tumoral mass
Fig.9
Fig.9
Evacuating the tumoral content, with further partial exeresis of the tumor
Fig.10
Fig.10
Suturing the ureter after intrasurgical installation of a double J ureteral stent
Fig.11,12
Fig.11,12
CT images –Large abdominal tumoral formation extending to the vesical cap
Fig.13
Fig.13
Laparotomy revealing the tumoral formation
Fig.14
Fig.14
Tumoral content (yellowish jelly-like liquid)
Fig.15
Fig.15
The tumor capsule
Fig.16
Fig.16
Intrasurgery image of the retroperitoneal tumoral formation located between the lombar spine and the big blood vessels, and incorporating the lombar ureter.
Fig.17,18
Fig.17,18
Intrasurgery images – termino-terminal anastomosis of the ureter extremities, after excision of the intra-tumoral ureter and intrasurgery installation of a double J ureteral stent
See this image and copyright information in PMC

References

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