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[Computed tomography of retroperitoneal neoplasms].

CT findings of retroperitoneal neoplasma in 50 cases (51 tumors) were reviewed. There were 28 (55%) malignant tumors and 23 (45%) benign ones. MFH and liposarcoma were the most common malignant tumors and neural origin tumors were the most common benign ones. Differentiation is difficult on the basis of CT features alone. Benign tumors were usually smooth and well defined, and malignant ones ill-defined, irregular in shape, heterogenous in density with massive necrosis. The characteristic CT appearance of liposarcoma is the CT attenuation value by fat density. Neural origin tumors are usually located near the spine. They may have thick wall cystic appearance or are dumbbell shaped, showing expansion or extrinsic pressure to the adjacent bone structures. MFH, hemangiopericytoma and other malignant tumors may have marked enhancement after contrast administration. Non-resectability is shown as: 1. big vessels encased by tumor over 90 degrees, 2. adjacent organs or structures invaded by tumor, 3. multiple masses, and 4. huge tumor invading into the pelvis. Local recurrence is common after surgery. Follow-up CT scans every 6 months in a 2 year period is suggested for early detection of recurrence.

Adult

[Sonographic and roentgenologic course controls following radiotherapy of retroperitoneal neoplasms].

Twelve patients with retroperitoneal tumors were examined sonographically and roentgenologically before and after radiation therapy. The sonograms were evaluated quantitatively by planimetry. Nine cases revealed analogous results in roentgenologic and in sonographic examinations. In three cases sonography revealed a tumor regression which was not verifiable with X-rays. In consideration of these results, sonography is used by us as a primary method for examination of retroperitoneal tumors during the follow-up control.

Humans

[Nonorganic retroperitoneal neoplasms of the pelvis].

The results of observations over 116 patients with nonorganic retroperitoneal tumors of the pelvis in the diagnosis of which computerized and ultrasonic tomography were used among other methods showed these methods to expand the possibilities of early diagnosis significantly. Analysis of 83 operations conducted on patients with nonorganic tumors of the pelvis revealed the main reasons why a radical operative intervention failed to be performed. Hemorrhage and pyo-inflammatory processes in the pelvic fat were the most common and serious complications in the postoperative period.

Adolescent

Giant kidney worm (Dioctophyma renale) infection mimicking retroperitoneal neoplasm.

A 50-year-old Chinese man was found by ultrasound and computed tomography to have a retroperitoneal mass in the right upper quadrant of the abdomen. At operation, a hemorrhagic cyst was detected at the upper pole of the right kidney adjacent to the adrenal gland. Microscopic examination revealed that the cyst wall was composed of granulomatous tissue loaded with eggs and cross-sections of parasites, identified as Dioctophyma renale. The eggs were characterized by a birefringent striated double wall. The presence of cross sections of adult worms of D. renale in human tissue has not been previously described. Another unique feature of this case was that the right kidney was intact, as examined grossly at laparotomy and by intravenous pyelography. Eggs were not detected in the urine.

Cysts

Primary retroperitoneal neoplasms: how close can we come in making the correct diagnosis.

The primary retroperitoneal tumors form a rare and diverse group of neoplasms, the origin of which is independent of the various retroperitoneal organs and unrelated to systemic diseases, such as lymphomas, lymphadenopathy, or metastases. Radiologic investigation, mainly cross-sectional imaging and, to a lesser extent, angiography is essential in the diagnosis and management of these tumors. The radiologist often is challenged to identify the origin and specific tissue composition of the imaged neoplasms. When the radiologic findings are combined with patient information and clinical data, the correct diagnosis may be made in many cases. Imaging-guided percutaneous needle biopsy further enhances the diagnostic yield of the various imaging modalities by establishing the diagnosis without the need for exploration.

Adolescent

[Splenoportography in pancreatic tumors and retroperitoneal neoplasms].

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.

Adult

Retroperitoneal fibrosis secondary to metastatic neoplasm.

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.

Adenocarcinoma

Retroperitoneal germ cell neoplasm: MR and CT.

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.

Cryptorchidism

Retroperitoneal teratoma.

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.

Adolescent