Successful resection of a huge retroperitoneal venous hemangioma: A case report

Abstract

Background: Venous hemangioma is a benign and non-invasive type of tumor, which is rarely identified due to the absence of clinical manifestations. A retroperitoneal benign tumor is comparatively rare, and hemangioma is exceptional. Because of the different types and locations of hemangioma, presentations are varied; thus, establishing an accurate diagnosis before surgery is challenging.

Case summary: A 45-year-old female patient visited our hospital with the complaint of a retroperitoneal mass without symptoms discovered during a medical examination. An abdominal and pelvic computed tomography (CT) revealed a giant hypodense mass that extended from the lower edge of the liver down to the right groin and showed no marked enhancement in the arterial phase of the enhanced CT. On magnetic resonance imaging, the retroperitoneal mass was hyperintense on the T2-weighted image and hypointense on the T1-weighted image. The mass was completely resected and confirmed as a venous hemangioma by pathology.

Conclusion: Venous hemangioma is rare in adults, and an accurate diagnosis before surgery is challenging. Surgery is the curative treatment for venous hemangioma, and the definitive diagnosis relies on pathology.

Keywords: Case report; Diagnosis; Retroperitoneal hemangioma; Venous hemangioma.

Figure 1

Imaging findings of a retroperitoneal mass. A: CT scans of the abdomen demonstrates a hypodense mass in the right retroperitoneum; B: The enhanced CT shows the mass without remarkable enhancement; C: On MRI, T1-weighted image shows the mass as low signal intensity without enhancement; D: T2-weighted image shows the mass with high signal intensity. CT: Computed tomography; MRI: Magnetic resonance imaging.

Figure 2

During operation, the cystic wall with duodenal adhesion was completely removed by laparotomy (as shown by the arrow).

Figure 3

Pathologic findings of the venous hemangioma. A: The specimen tissues are composed of various-sized cystic cavities with walls consisting of single-layered flattened cells; B: Immunohistochemically, the endothelial cells are positive for CD34; C: Some endothelial cells are positive for CD31; D: Some endothelial cells are positive for D2-40.