Solid Tumors of the Peritoneum, Omentum, and Mesentery in Children: Radiologic-Pathologic Correlation:From the Radiologic Pathology Archives

Abstract

Intraperitoneal solid tumors are far less common in children than in adults, and the histologic spectrum of neoplasms of the peritoneum and its specialized folds in young patients differs from that in older patients. Localized masses may be caused by inflammatory myofibroblastic tumor, Castleman disease, mesenteric fibromatosis, or other mesenchymal masses. Inflammatory myofibroblastic tumor is a mesenchymal tumor of borderline biologic potential that appears as a solitary circumscribed mass, possibly with central calcification. Castleman disease is an idiopathic lymphoproliferative disorder that appears as a circumscribed, intensely enhancing mass in the mesentery. Mesenteric fibromatosis, or intra-abdominal desmoid tumor, is a benign tumor of mesenchymal origin associated with familial adenomatous polyposis. Mesenteric fibromatosis appears as a mildly enhancing, circumscribed solitary mass without metastases. Diffuse peritoneal disease may be due to desmoplastic small round cell tumor (DSRCT), non-Hodgkin lymphoma, or rhabdomyosarcoma. DSRCT is a rare member of the small round blue cell tumor family that causes diffuse peritoneal masses without a visible primary tumor. A dominant mass is typically found in the retrovesical space. Burkitt lymphoma is a pediatric tumor that manifests with extensive disease because of its short doubling time. The bowel and adjacent mesentery are commonly involved. Rhabdomyosarcoma may arise as a primary tumor of the omentum or may spread from a primary tumor in the bladder, prostate, or scrotum. Knowledge of this spectrum of disease allows the radiologist to provide an appropriate differential diagnosis and suggest proper patient management.

Managing peritoneal involvement in children and young people with rhabdomyosarcoma: A single‐center experience from the United Kingdom

“…Diverse patterns of peritoneal involvement by CT have been described previously, including ascites, intraperitoneal nodules, peritoneal masses, mesenteric nodules, and omental caking. 2,7 Contrary to our findings where three patients had only solid peritoneal involvement at presentation, all patients with peritoneal disease at presentation in the North American study 2 had ascites.…”

“…Unlike the North American series, we noted peritoneal stranding, omental caking, and extensive plaque formation suggestive of high‐volume disease at progression/relapse. Omental caking, a feature of primary peritoneal disease, was seen at relapse in one of our patients with an extremity alveolar primary.…”

“…Diverse patterns of peritoneal involvement by CT have been described previously, including ascites, intraperitoneal nodules, peritoneal masses, mesenteric nodules, and omental caking …”

In ammatory myo broblastic tumor of the small bowel mesentery complicated by the intestinal obstruction

“…Сле-дует отметить, что в детской популяции большинство новообразований локализуется в забрюшинном про-странстве (нейробластома, нефробластома и т.д.). Поражение брюшной полости описано при ограни-ченном числе доброкачественных и злокачествен-ных новообразований, включающих рабдомиосаркому, десмопластическую мелкокруглоклеточную опухоль, фиброматоз брыжейки, лимфому Беркитта, сосуди-стые опухоли, ВМО, а также при ряде лимфопроли-феративных заболеваний (болезнь Кастлемана) [11]. Клиническая картина зависит от локализации пораже-…”

“…Солидные объемные образования брюшины, сальника и брыжейки у детей [11] Неполная резекция увеличивает риск развития реци-дивов. Частота развития рецидивов у пациентов с ВМО доходит до 25% [2].…”