Adult primary retroperitoneal cavernous hemangioma: a case report

Abstract

Primary retroperitoneal cavernous hemangioma (PRCH) in an adult is extremely rare. We report on the diagnosis and treatment of a patient with PRCH with subtle clinical features and atypical findings on imaging scans. A 38-year-old man was admitted to hospital with a 5-day history of epigastralgia after alcohol drinking. Using various imaging methods, we found a giant cyst-like retroperitoneal mass compressing the surrounding organs. Surgical resection of the tumor was performed, and the mass was found to be a cavernous hemangioma measuring 90 × 80 × 60 mm, with a thick fibrotic wall and extensive intracystic hemorrhage. Physicians should be aware that PRCH may mimic a cystic neoplasm, and that a large tumor size probably indicates intracystic hemorrhage. Surgical resection is a curative approach for PRCH.

Figure 1

Computed tomography scans. (A–C) Plain scan, artery phase, and portal phase, respectively, showed a cyst-like and well-encapsulated tumor, with mild enhancement of the wall on portal phase. (D–F) Coronal and transverse sections showed that the tumor was compressing the inferior vena cava, duodenum, and right upper ureter respectively (white arrows).

Figure 2

Clinical and histological findings. (A–C) Intra-operative, post-operative, and cross-slit findings of the tumor. (A) The blue, black and yellow arrows indicate tumor, right upper ureter, and inferior vena cava. respectively. (D,E) Stains confirmed the components of the tumor. (D) Hematoxylin and eosin, original magnification ×40; (E) CD34, original magnification × 40.