Retroperitoneal mucinous cystadenocarcinoma: a case report and review of literature

Tangjitgamol, Siriwan; Manusirivithaya, S.; Sheanakul, C.; Leelahakorn, Surawute; Thawaramara, T.; Kaewpila, N

doi:10.1046/j.1525-1438.2002.01120.x

Cited by 36 publications

(44 citation statements)

References 16 publications

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“…The ultrastructural findings and immunohistochemical observations support this hypothesis [10]. The age at diagnosis ranges from 17 to 86 years old and the most common complaint at presentation has been abdominal discomfort and a slow-growing pelvic or abdominal mass [7,11]. Ovarian neoplasm rather than retroperitoneal neoplasm was suspected in our patient.…”

Section: Discussionsupporting

confidence: 67%

“…CA 19-9 was slightly elevated in our patient, but tumor markers are not very helpful in differentiating the exact origin of the lesion, because CA-125, CA 19-9 may or may not be elevated. Tumor markers help in detecting a recurrent tumor, as in ovarian neoplasm [11]. The treatment of primary retroperitoneal mucinous cystadenocarcinoma remains controversial and no evidence based management guidelines are available.…”

Section: Discussionmentioning

confidence: 99%

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A case of primary retroperitoneal mucinous cystadenocarcinoma treated with fertility-sparing surgery

Chung

Lee

2012

Korean J Obstet Gynecol

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Primary retroperitoneal mucinous cystadenocarcinoma is an extremely rare tumor. Preoperative diagnosis is very diffi cult and the treatment remains controversial. A 37-year-old Korean woman (gravida 0) presented with a huge abdominal mass. Computed tomography scan revealed an 18 × 11 cm sized unilocular cyst with irregular wall thickening and solid component at right adnexa. Serum CA 19-9 was slightly elevated (37.05 U/mL). At laparotomy, a huge right retroperitoneal cystic tumor originating from right paracolic gutter was found. Frozen section of the cystic tumor revealed a mucinous cystadenocarcinoma. Because the patient wished to remain fertile, fertility sparing surgery was performed. Microscopically, no evidence of metastasis was found and no further treatment was given. Six months after surgery, she has no evidence of recurrence. Fertility-sparing surgery should be considered for women with primary retroperitoneal mucinous cystadenocarcinoma, who wish to remain fertile. Copyright © 2012. Korean Society of Obstetrics and GynecologyPrimary retroperitoneal mucinous cystadenocarcinoma is an extremely rare tumor. To date, about 50 cases have been reported [1]. The histogenesis of this unusual neoplasm is not clear. In the majority of cases, preoperative diagnosis is not possible because radiologic study such as ultrasonography or computed tomography (CT) scan is not able to distinguish the exact origin of the lesion. Due to its rarity, the treatment of primary retroperitoneal mucinous cystadenocarcinoma remains controversial. Most of these cases were treated with radical surgery, including total hysterectomy and bilateral salpingo-oophorectomy with enucleation of retroperitoneal tumor [2]. But, fertility-sparing surgery also have been adopted for the treatment of primary retroperitoneal mucinous cystadenocarcinoma and showed good prognosis [1,2]. Here, we report on a case of primary retroperitoneal mucinous cystadenocarcinoma treated with fertility-sparing surgery. Case ReportA 37-year-old Korean woman (gravida 0) presented with a huge abdominal mass. The patient reported that she had had abdominal discomfort since 1 month ago and visited local clinic. On abdominal ultrasonography, a huge abdominal mass was detected and she was referred to department of gynecology. Her previous menstrual history was regular and past medical history was noncontributory. On physical examination, her abdomen was markedly distended. CT scan revealed an 18×21 cm sized unilocular cyst with irregular wall thickening and solid component at right adnexa (Fig. 1). Neither enlarged regional lymph node nor ascites was found. Hydronephrosis of right kidney and multiple uterine myomas were found. Laboratory analyses showed normal blood counts and nor-CASE REPORT Korean J Obstet Gynecol 2012;55(6):424-428 http://dx

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

A case of primary retroperitoneal mucinous cystadenocarcinoma treated with fertility-sparing surgery

Chung

Lee

2012

Korean J Obstet Gynecol

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“…However, Tangjitgamol et al hypothesized that tumor markers may help in determining a recurrent tumor, such as colon cancer (11). In our case, CEA and CA19-9 reached levels of 970 ng/ml and 1762 U/ml, respectively, 4 months after sugery and a CT scan confirmed local recurrences in the retroperitoneum.…”

Section: Retroperitoneal Primary Mucinous Adenocarcinomamentioning

confidence: 50%

Retroperitoneal primary mucinous adenocarcinoma: A case report

et al. 2011

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Abstract. Retroperitoneal primary mucinous adenocarcinoma (RPMA) is extremely rare and the histogenesis of this tumor remains unclear. There is no consensus on the appropriate treatment for RPMA. Surgical resection is standard for the treatment of RPMA, whereas the benefits of chemotherapy with regard to this tumor remain to be established. This case report concerns a 21-year-old female individual with RPMA. The patient initially presented with chronic lower back pain and weight loss. Additionally, carcinoembryonic antigen (CEA) levels were found to be elevated. A computed tomography scan revealed a mass in the abdominal cavity. Consequently, laparotomy was performed, which revealed a well-defined tumor in the right retroperitoneum. Chemotherapy as a monotherapy was not considered as a viable treatment option. Therefore, the patient was initially administered a combined treatement of oxaliplatin and 5-fluorouracil. This treatment was then changed to paclitaxel and 5-fluorouracil. Findings showed a decrease in the CEA serum levels, indicating that this combination treatment may be efficacious in the treatment of RPMA since local recurrence following surgical resection was well controlled with chemotherapy. IntroductionRetroperitoneal primary mucinous adenocarcinoma (RPMA) is extremely rare and the histogenesis of this tumor remains unknown. As with most retroperitoneal masses, RPMA causes clinical symptoms or is perceived by patients only when the mass grows to a sufficiently large size. Laboratory studies lack the appropriate levels of specialization for this tumor and imaging methods merely reveal cystic lesions, neither of which result in accurate diagnosis. Surgical resection is standard for the treatment of RPMA, whereas chemotherapy for this tumor has not been rendered an efficacious treatment modality. This case study reports a 21-year-old woman with RPMA. Following laparotomy, combined treatments were administered and the benefits thereof were investigated. Case reportA 21-year-old woman presented with chronic lower back pain and weight loss for a period of 10 months. Her physical examination did not present any irregularities. She had no significant past medical histology or family history of disease. Laboratory data showed high levels of the carcinoembryonic antigen (CEA) (338.39 ng/ml) and carbohydrate antigen (CA) 19-9 (253.13 U/ml). A computed tomography (CT) scan revealed a mass measuring approximately 14.6x7.7 cm in the abdominal cavity with enlarged lymph nodes along the pancreas. There was a low-density area inside the mass, which was slightly heterogeneously enhanced (Fig. 1). Following a laparotomy, an adult fist-sized well-defined tumor was observed in the right retroperitoneum, which was covered with intact peritoneum. No ascites were noted, and the liver and kidneys appeared normal and were medially displaced. During surgical resection the mass, which consisted of multiloculated cyst with abundant intracytoplasmic mucin was ruptured. The microscopic examination confirmed a mucinous adenocarc...

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“…The mucinous cystadenoma cysts are lined by a single layer of tall columnar epithelial cells, with pale cytoplasm and basal nuclei (30)(31)(32). Notably, even if benign per se, these lesions could transform into malignant cystadenocarcinoma (33)(34)(35)(36). Upon CT scan, mucinous cystadenoma does not display specific characteristics over the other cystic retroperitoneal masses (37).…”

Section: Discussionmentioning

confidence: 99%

Detection and management of retroperitoneal cystic lesions: A case report and review of the literature

et al. 2017

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Abstract. The identification of cystic lesions within the retroperitoneal space is a rare event that poses clinicians the challenge of a difficult diagnosis and disease management. Retroperitoneal cystic lesions account for a group of lesions that range from common benign lesions (e.g., lymphoceles developing as a surgical complication) to rare aggressive malignant neoplasms. Currently, in the majority of cases, image-guided procedures allow for a pathological diagnosis to be achieved in these challenging lesions, thus offering the chance of an appropriate treatment; however, the overall clinical assessment of retroperitoneal cysts is highly demanding. The present study reports the management of a representative clinical case, presenting with a voluminous cystic mass able to dislocate cave vein, whose diagnosis was preceded by a deep vein thrombosis. Computed tomography-scan and ultrasound guided percutaneous drainage were performed to achieve the diagnosis. Following the discussion of the current case report, a review of the pathological and radiological characteristics of retroperitoneal cystic lesions is presented.

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Retroperitoneal mucinous cystadenocarcinoma: a case report and review of literature

Cited by 36 publications

References 16 publications

A case of primary retroperitoneal mucinous cystadenocarcinoma treated with fertility-sparing surgery

A case of primary retroperitoneal mucinous cystadenocarcinoma treated with fertility-sparing surgery

Retroperitoneal primary mucinous adenocarcinoma: A case report

Detection and management of retroperitoneal cystic lesions: A case report and review of the literature

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