Germinal tumors exhibiting the endodermal sinus pattern of Teilum in young children.
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Brief literature data on clinico-morphologic manifestation of retroperitoneal paraganglioma and its differential diagnosis with ectopic pheochromocytoma is presented. A female 31-year old patient is described with a rapid growth of retroperitoneal neoplasm and a concomitant increase of arterial blood pressure, first paroxysmal and then permanent. After the tumor excision (10 X 13 X 16 cm in size), not connected with the adrenal, the blood pressure recovered. The morphologic study provided the evidence for malignant paraganglioma different from ectopic pheochromocytoma in structural polymorphism and small size of neurosecretory granules. The arterial blood pressure increase is suggested to be due to tumor compression on the left kidney vessels.
A case of germ cell neoplasm in an undescended retroperitoneal testicle is reported. CT revealed a large mass most consistent with a chronic hematoma. MRI demonstrated findings typical for neoplasm, and this was confirmed on biopsy.
Retroperitoneal teratoma is the third most common primary retroperitoneal neoplasm of childhood ranking behind neuroblastoma and nephroblastoma. Ten per cent of these tumors are malignant. Two cases of benign retroperitoneal teratoma are reported, and the first description of the angiographic appearance of such a tumor is presented.
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OBJECTIVE: To describe an additional case of retroperitoneal schwannoma. METHODS: A case of retroperitoneal neoplasm in a 29-year-old woman is presented. The clinical and therapeutic aspects are discussed. RESULTS: The anatomopathological study showed a benign schwannoma. CONCLUSIONS: Retroperitoneal schwannoma is an uncommon lesion that is difficult to diagnose preoperatively. Treatment is by surgical resection.
Magnetic resonance (MR) imaging has an increasing role in evaluating soft-tissue masses of the extraperitoneal spaces. Since the MR imaging features of most soft-tissue masses are nonspecific, prediction of a specific histologic diagnosis remains a challenge for the radiologist. However, there are certain specific MR imaging appearances that are helpful for more accurate diagnosis. Some histologic components, such as myxoid stroma, collagen fibers, calcification, and fat, have characteristic MR imaging features. Recognition of these features can assist the radiologist in limiting the differential diagnosis. Dynamic enhancement patterns can reflect the vascularity of masses and may be useful in diagnosis, especially in differentiating benign from malignant soft-tissue masses. Familiarity with specific signs and knowledge of diagnostic pitfalls are also important for shortening the list of differential diagnoses. Specific signs are the target sign, the bowl of fruit sign, a whorled appearance, a flow void, speckled enhancement, associated lymphadenopathy, and extension into the intervertebral foramen. Diagnostic pitfalls are as follows: a myxoid stroma simulating cystic degeneration and necrosis, collagen fibers simulating hemorrhage, a fat component simulating extraperitoneal fat, extensive intratumoral hemorrhage simulating hematoma, benign masses mimicking malignant ones, malignant masses mimicking benign ones, and peritoneal lesions mimicking extraperitoneal masses.
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