Perirenal fat necrosis secondary to hemorrhagic pancreatitis, mimicking retroperitoneal liposarcoma: CT manifestation

Chen, H.-C.; Tsang, Y.-M.; Wu, Chien-Hui; Su, Cheng-Tau; Hsu, Jane Chien-Yao

doi:10.1007/s002619900123

Cited by 13 publications

(6 citation statements)

References 7 publications

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“…The process may extend into the various retroperitoneal compartments, the small bowel mesentery, and the transverse mesocolon. The process may traverse the strong perinephric fascia to involve the perinephric compartment (59). A clinical history of a prior episode of acute pancreatitis is usually helpful in establishing the diagnosis.…”

Section: Retroperitoneal Fat Necrosis-retroperitonealmentioning

confidence: 99%

Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis

Shaaban¹,

Rezvani²,

Tubay³

et al. 2016

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The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is easily recognized because of its characteristic imaging appearance. It typically is hyperechoic at ultrasonography and demonstrates low attenuation at computed tomography (-10 to -100 HU). Magnetic resonance imaging is a more ideal imaging modality because it has better soft-tissue image contrast and higher sensitivity for depicting (a) microscopic fat by using chemical shift imaging and (b) macroscopic fat by using fat-suppression techniques. Whether a lesion arises from a retroperitoneal organ or from the soft tissues of the retroperitoneal space (primary lesion) is determined by examining the relationship between the lesion and its surrounding structures. Multiple imaging signs help to determine the organ of origin, including the "beak sign," the "embedded organ sign," the "phantom (invisible) organ sign," and the "prominent feeding artery sign." Adrenal adenoma is the most common adrenal mass that contains microscopic fat, while myelolipoma is the most common adrenal mass that contains macroscopic fat. Other adrenal masses, such as pheochromocytoma and adrenocortical carcinoma, rarely contain fat. Renal angiomyolipoma is the most common fat-containing renal mass. Other fat-containing renal lesions, such as lipoma and liposarcoma, are rare. Fatty replacement of the pancreas and pancreatic lipomas are relatively common, whereas pancreatic teratomas are rare. Of the primary retroperitoneal fat-containing lesions, lipoma and liposarcoma are common, while other lesions are relatively rare. (©)RSNA, 2016.

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Section: Retroperitoneal Fat Necrosis-retroperitonealmentioning

confidence: 99%

Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis

Shaaban¹,

Rezvani²,

Tubay³

et al. 2016

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“…Occasionally, encapsulated fat necrosis is associated with inflammation and calcification ( Fig 18) (10). Its imaging appearance may be complex, with mild mass effect on adjacent structures that may mimic a liposarcoma (Figs 19, 20) (20)(21)(22). The capsule that surrounds areas of fat necro-sis may weakly enhance after administration of contrast material, a finding that further simulates malignancy (19).…”

Section: Encapsulated Fat Necrosismentioning

confidence: 99%

“…After resolution of the acute exudate and ascites in pancreatitis, scattered nodules of fat necrosis may be seen throughout the retroperitoneum and abdominal cavity (Figs 25, 26). These nodules may exhibit mass effect and delayed contrast enhancement, possibly a result of the slow diffusion of contrast material through small capillaries in granulation tissue (21,27). A clinical history or imaging studies that demonstrate previous episodes of pancreatitis may be necessary to distinguish nodular fat necrosis from peritoneal carcinomatosis at imaging.…”

Section: Fat Saponification and Pancreatitismentioning

confidence: 99%

Imaging Manifestations of Abdominal Fat Necrosis and Its Mimics

Kamaya¹,

Federle²,

Desser³

2011

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Intraabdominal fat is a metabolically active tissue that may undergo necrosis through a number of mechanisms. Fat necrosis is a common finding at abdominal cross-sectional imaging, and it may cause abdominal pain, mimic findings of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Common processes that are present in fat necrosis include torsion of an epiploic appendage, infarction of the greater omentum, and fat necrosis related to trauma or pancreatitis. In addition, other pathologic processes that involve fat may be visualized at computed tomography, including focal lipohypertrophy, pathologic fat paucity (lipodystrophies), and malignancies such as liposarcoma, which may mimic benign causes of fat stranding. Because fat necrosis and malignant processes such as liposarcoma and peritoneal carcinomatosis may mimic one another, knowledge of a patient's clinical history and prior imaging studies is essential for accurate diagnosis.

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“…The most common locations of fat necrosis in the presence of pancreatitis are the peripancreatic adipose tissue, the omentum and mesentery, but a predilection for the retroperitoneum has been reported with greater involvement of left kidney, especially the posterior pararenal space without penetration of the peritoneal space or fat; explaining cases reported as mimickers of renal cell carcinoma and liposarcoma. 8,9 Since Pedrosa's original report there has been one case of perirenal fat necrosis secondary to alcoholic pancreatitis reported by Fumado Ciutat et al 10 Persistence of radiologic findings for more than one year following the acute episode prompted surgical resection.…”

Section: Case Reportmentioning

confidence: 99%

Renal Pseudotumor Due to Perirenal Fat Necrosis

Urrego¹,

Ang²,

Laskow³

et al. 2012

N A J Med Sci

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We report the findings of an uncommon non-infectious cause of renal pseudotumor, perirenal fat necrosis, presenting as a native kidney mass in a renal transplant recipient. Resection was performed due to clinical suspicion for malignancy. To our knowledge this is the first report of a case of perirenal fat necrosis presenting in the transplant setting. This case emphasizes the need to continually expand our diagnostic considerations beyond epithelial and non-epithelial malignancies when confronted with native kidney masses in renal transplant recipients.

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Perirenal fat necrosis secondary to hemorrhagic pancreatitis, mimicking retroperitoneal liposarcoma: CT manifestation

Cited by 13 publications

References 7 publications

Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis

Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis

Imaging Manifestations of Abdominal Fat Necrosis and Its Mimics

Renal Pseudotumor Due to Perirenal Fat Necrosis

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