Detection and management of retroperitoneal cystic lesions: A case report and review of the literature

Abstract

Abstract. The identification of cystic lesions within the retroperitoneal space is a rare event that poses clinicians the challenge of a difficult diagnosis and disease management. Retroperitoneal cystic lesions account for a group of lesions that range from common benign lesions (e.g., lymphoceles developing as a surgical complication) to rare aggressive malignant neoplasms. Currently, in the majority of cases, image-guided procedures allow for a pathological diagnosis to be achieved in these challenging lesions, thus offering the chance of an appropriate treatment; however, the overall clinical assessment of retroperitoneal cysts is highly demanding. The present study reports the management of a representative clinical case, presenting with a voluminous cystic mass able to dislocate cave vein, whose diagnosis was preceded by a deep vein thrombosis. Computed tomography-scan and ultrasound guided percutaneous drainage were performed to achieve the diagnosis. Following the discussion of the current case report, a review of the pathological and radiological characteristics of retroperitoneal cystic lesions is presented.

Rare huge retroperitoneal cystic lymphangioma presenting as acute abdomen in an adult

“…Diagnosis and approach to management of cystic retroperitoneal lesions can be highly challenging and pre- operative diagnosis complex. 6 Rare presentation of retroperitoneal lymphangioma in adults may make radiological diagnosis even more challenging. Ultrasonography, CT, MRI and laparoscopy are useful in diagnosis although the definitive diagnosis requires histology and an immunohistochemistry.…”

“…The MRI finding is that of well-defined round or oval uniformly dense cystic masses with long signal intensity on T 1 and T 2 weighted images. 6 The ability of MRI to provide images in multiple planes with no loss of resolution may demonstrate additional lesions and further delineate the boundaries of the cysts. 11 MRI allows a detailed assessment of the lesions morphology and structure, shows vessel-like internal septa, wall thickness and fluid content better.…”

Retroperitoneal cystic mass: a diagnostic challenge

“…Preoperative biopsy or fine‐needle aspiration may assist in clinching the diagnosis in some cases but the procedure itself is not risk‐free. With the currently available diagnostic modalities, it is difficult to differentiate between the benign and the malignant masses . Lack of proven diagnostic algorithms has made the diagnostic approach to such lesions an arduous task.…”

“…With the currently available diagnostic modalities, it is difficult to differentiate between the benign and the malignant masses. 3 Lack of proven diagnostic algorithms has made the diagnostic approach to such lesions an arduous task. In the present case, the patient was operated with a preoperative diagnosis of cystic teratoma, only to be diagnosed as hydatid cyst intraoperatively.…”

Primary retroperitoneal mucinos cystadenoma: A case report

“…Primarni retroperitonealni mucinozni cistadenom može se javiti i kod žena koje imaju potpuno zdrave jajnike (29) skoro 80% retroperitonealnih tumora pokazuje maligne karakteristike, za sada još ne postoje jasne dijagnostičke smernice za PrMC (30). u zavisnosti od toga kojoj vrsti tumora pripada (primarni retroperitonealni mucinozni cistadenom, primarni retroperitonealni cistadenom sa graničnim malignitetom i PrM cistadenoakrcinom) savetuje se i dalje lečenje nakon totalne enukleacije.…”