[Primary retroperitoneal neoplasms].
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A case of Castleman disease of the retroperitoneum in a 26-year-old woman is presented. Sonography, computed tomography, and magnetic resonance imaging demonstrated a large retroperitoneal mass with somewhat heterogeneous imaging characteristics. Although a definitive preoperative diagnosis was not possible, magnetic resonance imaging was useful in delineating the extent of the tumor and defining the characteristics of surrounding soft tissues.
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Along with other methods of investigation splenoportography was performed in 29 patients with tumors and in 2 patients with cystic affection of the pancreas. Moreover, in 5 cases splenoportography was performed due to a suspicion to pancreatic tumor, and also in 6 patients with retroperitoneal tumors and in 7-with renal tumors. In all these patients with pancreatic tumors splenoportograms have shown changes on the part of a splenoportal trunk, which corresponded to the localization and degree of spread of a tumor in most cases. Splenoportography is felt to be rational in retroperitoneal tumors. In such cases splenoportography would contribute to a detailed determination of tumor localization and its relation with the liver.
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Retroperitoneal fibrosis may occur secondary to metastatic neoplasm and may simulate the features of the idiopathic variety. A case of retroperitoneal fibrosis due to gastric carcinoma is presented and the historical, physical, cystoscopic, urographic, operative, and pathologic similarities to the idiopathic form discussed. Generous biopsy of retroperitoneal plaques and careful pathologic examination are stressed to avoid missing malignant disease.
We describe a retroperitoneal neoplasm in an 11-year-old girl which had a light microscopic appearance identical to that of papillary serous carcinoma of the ovary. There was no evidence of ovarian involvement. Immunohistochemical staining for amylase was positive within the cytoplasm of tumor cells. Since amylase is a marker for serous ovarian tumors, this finding supports the belief that "ovarian-type" neoplasms that occur at ectopic locations are essentially identical to their ovarian counterparts. We believe they originate from metaplasia of mesothelium. Our findings support the concept that these tumors should exhibit a biologic behavior and therapeutic response which are similar to those of an ovarian tumor of the same grade and comparable stage. The demonstration of intracytoplasmic amylase also may prove useful in differentiating peritoneal serous tumors from non-metaplastic mesothelial proliferations. We are unaware of a prior report of an extra-ovarian serous carcinoma in a child.