Why perirenal disease does not extend into the pelvis: the importance of closure of the cone of the renal fasciae.

Soft-Tissue Sarcomas of the Abdomen and Pelvis: Radiologic-Pathologic Features, Part 1—Common Sarcomas:From the Radiologic Pathology Archives

“…Superiorly, the perirenal space is closed by the fusion of the Gerota and Zuckerkandl fasciae with each other and the diaphragm (Fig 2a). Inferiorly, controversy continues to exist about whether there is fusion between the perirenal fascial layers, resulting in caudal closure of the perirenal space, or if this space remains open because of blending of the fascia with adjacent adipose tissue (10). Nevertheless, retroperitoneal sarcomas may grow longitudinally within the retroperitoneum to extend cranially toward the diaphragm and caudally into the pelvis.…”

Resection of Pancreas and Duodenum During Radical Nephrectomy: Analysis of A Single Center Experience

“…Adjacent visceral invasion is rare in RCC, likely due to the protective nature of the anterior and posterior renal fasciae [19]; In cases where RCC has spread to other organs, aggressive surgical extirpation such as upfront nephrectomy with or without metastasectomy has been advocated as the standard of care for those fit to withstand aggressive surgical interventions [20,21].…”

Medial pathway patterns of the right retromesenteric plane: anatomical investigation using MDCT in patients with acute pancreatitis and pyelonephritis

“…In the caudal aspect of the renal fascia (retromesenteric plane), two pathways have been postulated. One pattern is the closure of the caudal cone of the right renal fasciae (retromesenteric planes) 14,18 and the other pattern is the opening of the caudal apex of the perirenal space towards the iliac fossa.…”

“…1,[6][7][8]10 In many previous literature, configurations of the retroperitoneal planes have been analyzed by using cadaveric models and investigating the distribution of the thickened fascial planes and fluid collections in patients with retroperitoneal pathologies. 1,3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] However, there have been only two previous literature regarding the medial pathways of the right retromesenteric plane. 3,9 The right retromesenteric plane separating the anterior pararenal space from the perirenal space is thought to be composed of the left leaf of the primary mesocolon, primary parietal peritoneum and anterior renal fascia in front of the right kidney, and the right leaf of the primary mesoduodenum, primary parietal peritoneum and anterior renal fascia behind the pancreatic head and descending duodenum ( Figure 1).…”