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Case Reports
. 2024 Sep;15(Suppl 3):483-492.
doi: 10.1007/s13193-024-02039-0. Epub 2024 Jul 27.

Suprahilar and Retrocrural Domains in RPLND for NSGCT Testis-Going Beyond Where the Light Touches!

Shrinivas Venkatesh  1 , Malar Raj Phillips  1 , Shalini Shree Krishnamurthy  1 , Krishna Suresh  2 , Kanuj Malik  3 , Ayaloor Seshadri Ramakrishnan  1 , Arvind Krishnamurthy  1 , Hemanth Raj Ellusamy  1 , Anand Raja  1
Affiliations
Case Reports

Suprahilar and Retrocrural Domains in RPLND for NSGCT Testis-Going Beyond Where the Light Touches!

Shrinivas Venkatesh et al. Indian J Surg Oncol. 2024 Sep.
No abstract available

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Conflict of interest statement

Conflict of InterestThe corresponding author is a sectional editor for the Indian Journal of Surgical Oncology.

Figures

Fig. 1
Fig. 1
An artist’s representation of the structures traversing the retrocrural space
Fig. 2
Fig. 2
Post-chemotherapy contrast-enhanced computed tomography scan. A The arterial phase with the mass in close proximity to the celiac axis and B the diaphragmatic crura near the mass
Fig. 3
Fig. 3
A large bulge was noted intraoperatively in the vicinity of the caudate lobe and the esophago-gastric junction
Fig. 4
Fig. 4
Post-chemotherapy cross-sectional imaging. (A1) A large posterior mediastinal mass with its cranial limit extending up to the right inferior pulmonary vein. (A2) The mass closely abutting the aorta. (B) The mass abutting the left crus of the diaphragm. (C) The abdominal extent of the mass, with left hydroureteronephrosis
Fig. 5
Fig. 5
A large retroperitoneal conglomerate mass noted, encasing the left renal hilum
Fig. 6
Fig. 6
The operative field post suprahilar dissection, with bare aorta, vertebral column, and renal bed
Fig. 7
Fig. 7
The retrocrural mass noted in situ. As illustrated in Fig. 7A, the renal vein is secured with a blue loop which facilitates atraumatic retraction. Adequate oesophageal mobilization helps in unambiguously delineating the limit of dissection. Figure 7B showcases the relationships between the retrocrural nodal mass and the surrounding structures viz a viz the diaphragmatic crura and the esophagus
Fig. 8
Fig. 8
The extent of oesophageal mobilization
Fig. 9
Fig. 9
An artist’s representation of the structures surrounding the retrocrural mass
Fig. 10
Fig. 10
Tumour bed noted post-resection
Fig. 11
Fig. 11
A The right retrocrural mass in situ. B The CT image of the left retrocrural nodal mass closely related to the aorta and celiac axis
Fig. 12
Fig. 12
The retrocrural space laid bare
Fig. 13
Fig. 13
The oesophageal muscle closed and hiatus approximated to the oesophagus, with Prolene
Fig. 14
Fig. 14
Postoperative contrast-enhanced CT scan of the chest in the second patient, in the venous phase. There is no evidence of residual tumour. Right lower lobe lung consolidation is noted
See this image and copyright information in PMC

References

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