Large retroperitoneal hemangioma encompassing the renal vein

Abstract

Retroperitoneal hemangioma (RH) is a rare and benign vascular malformation. RH may be detected incidentally or present with symptoms due to local invasion of adjacent structures. Management options include surgical resection, as well as serial observation with routine imaging. We describe a retroperitoneal hemangioma encompassing the renal vein that was discovered during diagnosis of acute appendicitis, and characterize diagnostic magnetic resonance imaging (MRI) findings seen with this condition.

Fig. 1.

Coronal reformat from the contrast CT scan shows a relatively hypovascular mass (arrow) in the left retroperitoneum medial to the left kidney, encasing the left renal vein (double arrows).

Fig. 2.

Axial T2 fat-suppressed MR image shows the mass (arrow) to have a high-signal intensity compared to the adjacent kidney.

Figs. 3a–c:

MR axial pre- (a), arterial- (b), and delayed- (c) phase images show gradual enhancement of the mass (arrow). There was no evidence of involvement of the adjacent kidney, however, the left renal vein was encased by the mass.