CT and MR Imaging of Retroperitoneal Sarcomas: A Practical Guide for the Radiologist

Abstract

Primary retroperitoneal sarcomas (RPS) represent around 10–16% of all sarcomas, with liposarcomas and leiomyosarcomas being the most common subtypes. RPS have some peculiar characteristics, imaging appearances, worse prognosis, and complications compared to other locations of sarcoma. Commonly, RPS primarily present as large masses, progressively encasing adjacent structures, causing mass effect, and complications. RPS diagnosis is often challenging, and these tumors may be overlooked; however, failure to recognize RPS characteristics leads to a worse prognosis for the patients. Surgery is the only recognized curative treatment, but the anatomical constraints of the retroperitoneum limit the ability to achieve wide resection margins; therefore, these tumors have a high rate of recurrence, and require long-term follow-up. The radiologist has an important role in the diagnosis of RPS, the definition of their extent, and their follow-up. Specific knowledge of the main imaging findings is required to reach an early diagnosis, and, ultimately, to guarantee the best patient management. This article provides an overview of the current knowledge regarding cross-sectional imaging features of patients with retroperitoneal sarcomas, presenting tips and tricks to improve imaging diagnosis of RPS.

A rare presentation of retroperitoneal liposarcoma presented with jejunal intussusception: An interesting radiological findings

“…Organ displacement or invasion can also be found, as it did in ours for instance [ 7 , 8 , 9 ]. Despite the mass's location and origin, the CT scan can provide information on tissue composition (such as lipomatous components, calcifications or myxoid elements, and internal necrosis), all of which are crucial for determining the potential RLPS type and other diagnostic options to take into account [ 10 ]. When neurovascular and muscle invasion is suspected, magnetic resonance imaging may be helpful.…”

Correlation between imaging and histology in benign solitary retroperitoneal nerve sheath tumors: a pictorial review

“…In addition, RBNSTs' density and intensity depend on spontaneous intralesional rearrangements [18,19], such as . While cystic degeneration is present in a significant proportion of Schwannomas, it cannot be considered a distinctive hallmark due to its occurrence in retroperitoneal sarcomas as well [17,20].…”