Retroperitoneal tumours: review of management

Abstract

The retroperitoneum can host a wide spectrum of pathologies, including a variety of rare benign tumours and malignant neoplasms that can be either primary or metastatic lesions. Malignant tumours of the retroperitoneum occur four times more frequently than benign lesions.1 Sarcomas comprise a third of retroperitoneal tumours. Soft tissue sarcomas are rare tumours, with retroperitoneal sarcomas expected to compose approximately 15% of the 2,000 cases of soft tissue sarcomas anticipated in England and Wales each year.2 In the UK there are estimated to be between 250 and 300 new diagnoses of retroperitoneal sarcoma (RPS) each year. The retroperitoneum represents the second most common site of origin of malignant mesenchymal tumours after the lower extremities.3 Retroperitoneal tumours present several therapeutic challenges because of their relative late presentation and anatomical location (Fig 1). 4 This review highlights the presentation, evaluation and initial management of patients presenting with retroperitoneal tumours and the surgical management of RPS.A comprehensive literature search was conducted using PubMed. Relevant international articles published in the last ten years were assessed. The keywords for search purposes included: retroperitoneum, benign, sarcoma, neoplasm, diagnosis and surgery, radiotherapy, chemotherapy. The search was limited to articles published in English. All articles were read in full by the authors and selected for inclusion based on relevance to this article. BackgroundThe retroperitoneum represents a complex potential space with multiple vital structures bounded anteriorly by the peritoneum, ipsilateral colon and mesocolon, pancreas, liver or stomach. The posterior margins are by large composed of the psoas, quadratus lumborum, transverse abdominal and iliacus muscles but, depending on the tumour location and size, may be formed by the diaphragm, ipsilateral kidney, ureter and gonadal vessels. Similarly, the medial boundaries may include the spine, paraspinous muscles, the inferior vena cava (for right-sided tumours) and the aorta (for leftsided tumours). The lateral margin is formed by the lateral abdominal musculature and, depending on tumour location, may include the kidney and colon. Superiorly, retroperitoneal tumours may be in contact with the diaphragm, the right lobe The retroperitoneum can host a wide spectrum of pathologies, including a variety of rare benign tumours and malignant neoplasms that can be either primary or metastatic lesions. Retroperitoneal tumours can cause a diagnostic dilemma and present several therapeutic challenges because of their rarity, relative late presentation and anatomical location, often in close relationship with several vital structures in the retroperitoneal space. maTERiaLS and mEThodS a comprehensive literature search was conducted using Pubmed. Relevant international articles published in the last ten years were assessed. The keywords for search purposes included: retroperitoneum, benign, sarcoma, neoplasm, diagnosis and surgery, ra...

Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision Making Approach

“…The histological results of core needle biopsies are essential for accurate and precision therapeutic and diagnostic purposes in MDT decision-making approach [1]. In a considerable proportion of patients (25-29%) with uncertain origin of the lesion, the management of the disease did not require surgery [11]. Histological verification of the origin of the lesion is an essential prerequisite for further management [2].…”

Large-sized kidney tumor mimicking an extraorgan retroperitoneal tumor

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Ensuring a Safe and Qualitative Diagnostic Biopsy for Retroperitoneal Sarcomas

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