- Solid Retroperitoneal Tumors: Differential Dx
-Mesodermal neoplasms
-Neurogenic neoplasms
-Germ cell, sex cord, and stromal tumors
-Lymphoid and hematologic neoplasms - Mesodermal Neoplasms: Facts
-Liposarcoma, leiomyosarcoma and MFH make up more than 80% of these tumors
-Most common in 5th and 6th decades of life
-Often aggressive these tumors may be difficult to result and often recur locally or with metastases to liver, lung, bone, and brain - Liposarcoma of the Retroperitoneum: Facts
-Most common retroperitoneal sarcoma (33%)
-10-15% of all liposarcomas occur in the retroperitoneum
-Age range is usually 50-70 years of age
-Usually large with average size of 20 cm
-Four subtypes are well-differentiated, myxoid, pleomorphic and round cell. Well differentiated is most common in retroperitoneum - Retroperitoneal Leiomyosarcoma: facts
-Usually large (>10 cm) when discovered
-More common in woman and usually seen in the 5th to 6th decade of life
-On CT they are usually solid masses but may be cystic and necrotic as well
-6% of Leiomyosarcomas arise from the IVC and are primary in the IVC - Malignant Fibrous Histiocytoma (MFH) of the Retroperitoneum: Facts
-MFH is the most common sarcoma in the body and 15% arise in the retroperitoneum
-More common in male by 3-1 and most common in the 50-60 age group
-Mass may be solid or necrotic and may contain calcification in 7-20% of cases. This may be critical for the differential dx. - Other Retroperitoneal Sarcomas: Facts
-Rhabdomyosarcoma common in younger patients with bimodal peak at age 7 and then teen years
-Angiosarcoma, chondrosarcoma, synovial cell sarcoma all may occur but are rare. Synovial cell sarcoma usually occurs in patient 15-40 years of age which is younger than the other tumors
|
