Added value of contrast-enhanced ultrasound (CEUS) in the diagnosis of primary retroperitoneal serous adenocarcinoma: a case report

Abstract

Background Primary retroperitoneal serous adenocarcinoma (PRSA) is a rare malignant disease. Given the rarity of the disease, the imaging features of PRSA are unclear. Contrast-enhanced ultrasound (CEUS) also plays an important role in the evaluation of the differential diagnosis of retroperitoneal lesions. Case presentation We report the case of a 62-year-old woman of with increased CA125 levels for 1 year who was referred to our hospital. After conducting contrast-enhanced computed tomography and magnetic resonance imaging, the mass was misdiagnosed as a chocolate cyst. After transvaginal ultrasound (TUS) combined with CEUS, cystadenocarcinoma was considered as the initial diagnosis. Pathology results confirmed PRSA as the final diagnosis. Conclusions CEUS features of PRSA are reported for the first time based on this case, potentially aiding in the differential diagnosis of this rare entity before surgery.

Primary Retroperitoneal Carcinomas: New Insights into Pathogenesis and Clinical Management in Comparison with Ovarian Carcinomas and Carcinoma of Unknown Primary

“…Histological subtypes of retroperitoneal epithelial carcinomas include mucinous [ 8 , 9 , 10 , 11 , 12 , 13 ], serous [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], endometrioid [ 30 , 31 , 32 , 33 , 34 ], clear cell [ 35 , 36 , 37 , 38 ], and carcinosarcoma [ 39 , 40 , 41 ]. Morphologically, mucinous, serous, and endometrioid tumors resemble the phenotype of the colon, fallopian tube, and endometrium, respectively [ 42 ].…”

“…Bilateral salpingo-oophorectomy with hysterectomy may be performed in patients with non-mucinous carcinomas, as concurrent adnexal serous carcinoma including intraepithelial carcinoma may exist [ 20 , 26 ]. Laparoscopic resection of retroperitoneal tumors is feasible, but the long-term safety is not fully evaluated [ 24 , 28 , 163 ]. For women who developed retroperitoneal tumors during pregnancy, the timing of surgery should be determined by both malignancy risk and obstetric considerations [ 168 ].…”

FDG PET/CT in Primary Retroperitoneal Serous Carcinoma

“…Of these, primary epithelial tumors are rare. Most primary retroperitoneal carcinomas are mucinous, thus primary retroperitoneal serous carcinoma is extremely rare, with only 15 cases having been reported 2–16 . Notably, these cases may include metastatic tumors from ovarian, fallopian tube, or peritoneal carcinoma 14 .…”

“…Most primary retroperitoneal carcinomas are mucinous, thus primary retroperitoneal serous carcinoma is extremely rare, with only 15 cases having been reported. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Notably, these cases may include metastatic tumors from ovarian, fallopian tube, or peritoneal carcinoma. 14 Because of its rarity, the optimal management, as well as its prognosis, is unclear.…”