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Adult primary retroperitoneal cavernous hemangioma: a case report.

He H, Du Z, Hao S, Yao L, Yang F, Di Y, Li J, Jiang Y, Jin C, Fu D - World J Surg Oncol (2012)

Bottom Line: Surgical resection of the tumor was performed, and the mass was found to be a cavernous hemangioma measuring 90 × 80 × 60 mm, with a thick fibrotic wall and extensive intracystic hemorrhage.Physicians should be aware that PRCH may mimic a cystic neoplasm, and that a large tumor size probably indicates intracystic hemorrhage.Surgical resection is a curative approach for PRCH.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pancreatic Disease Institute, Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.

ABSTRACT
Primary retroperitoneal cavernous hemangioma (PRCH) in an adult is extremely rare. We report on the diagnosis and treatment of a patient with PRCH with subtle clinical features and atypical findings on imaging scans. A 38-year-old man was admitted to hospital with a 5-day history of epigastralgia after alcohol drinking. Using various imaging methods, we found a giant cyst-like retroperitoneal mass compressing the surrounding organs. Surgical resection of the tumor was performed, and the mass was found to be a cavernous hemangioma measuring 90 × 80 × 60 mm, with a thick fibrotic wall and extensive intracystic hemorrhage. Physicians should be aware that PRCH may mimic a cystic neoplasm, and that a large tumor size probably indicates intracystic hemorrhage. Surgical resection is a curative approach for PRCH.

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Related in: MedlinePlus

Clinical and histological findings. (A–C) Intra-operative, post-operative, and cross-slit findings of the tumor. (A) The blue, black and yellow arrows indicate tumor, right upper ureter, and inferior vena cava. respectively. (D,E) Stains confirmed the components of the tumor. (D) Hematoxylin and eosin, original magnification ×40; (E) CD34, original magnification × 40.
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Figure 2: Clinical and histological findings. (A–C) Intra-operative, post-operative, and cross-slit findings of the tumor. (A) The blue, black and yellow arrows indicate tumor, right upper ureter, and inferior vena cava. respectively. (D,E) Stains confirmed the components of the tumor. (D) Hematoxylin and eosin, original magnification ×40; (E) CD34, original magnification × 40.

Mentions: A vertical midline incision and extensive Kocher maneuver was used for the surgery. A giant tumor was found, lying inferior and posterior to the pancreatic process and the third part of the duodenum, inferior and anterior to the hilum of the right kidney, which was compressing anteriorly and laterally on the inferior vena cava, medially on the right upper ureter and posteriorly on the duodenum (Figure2). No metastatic lesions were found in the peritoneum, abdominal organs, or pelvic organs. Radical resection of the tumor was completed in 3.5 hours, with an estimated blood loss of 200 ml. The feeding arteries of the tumor were found to originate from retroperitoneal tissue instead of from the abdominal artery or from other organs, and each vessel was ligated before the tumor was removed. There was no evidence intraoperatively of invasion of the inferior vena cava, ureter, renal capsule, pancreas, duodenum, or other surrounding organs. The post-operative period was uneventful, and the patient discharged home on day 9 after the operation. Resection of the tumor relieved the pressure on the neighboring structures and no obvious complications of the surrounding organs were found at the 3-month follow-up.


Adult primary retroperitoneal cavernous hemangioma: a case report.

He H, Du Z, Hao S, Yao L, Yang F, Di Y, Li J, Jiang Y, Jin C, Fu D - World J Surg Oncol (2012)

Clinical and histological findings. (A–C) Intra-operative, post-operative, and cross-slit findings of the tumor. (A) The blue, black and yellow arrows indicate tumor, right upper ureter, and inferior vena cava. respectively. (D,E) Stains confirmed the components of the tumor. (D) Hematoxylin and eosin, original magnification ×40; (E) CD34, original magnification × 40.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539936&req=5

Figure 2: Clinical and histological findings. (A–C) Intra-operative, post-operative, and cross-slit findings of the tumor. (A) The blue, black and yellow arrows indicate tumor, right upper ureter, and inferior vena cava. respectively. (D,E) Stains confirmed the components of the tumor. (D) Hematoxylin and eosin, original magnification ×40; (E) CD34, original magnification × 40.
Mentions: A vertical midline incision and extensive Kocher maneuver was used for the surgery. A giant tumor was found, lying inferior and posterior to the pancreatic process and the third part of the duodenum, inferior and anterior to the hilum of the right kidney, which was compressing anteriorly and laterally on the inferior vena cava, medially on the right upper ureter and posteriorly on the duodenum (Figure2). No metastatic lesions were found in the peritoneum, abdominal organs, or pelvic organs. Radical resection of the tumor was completed in 3.5 hours, with an estimated blood loss of 200 ml. The feeding arteries of the tumor were found to originate from retroperitoneal tissue instead of from the abdominal artery or from other organs, and each vessel was ligated before the tumor was removed. There was no evidence intraoperatively of invasion of the inferior vena cava, ureter, renal capsule, pancreas, duodenum, or other surrounding organs. The post-operative period was uneventful, and the patient discharged home on day 9 after the operation. Resection of the tumor relieved the pressure on the neighboring structures and no obvious complications of the surrounding organs were found at the 3-month follow-up.

Bottom Line: Surgical resection of the tumor was performed, and the mass was found to be a cavernous hemangioma measuring 90 × 80 × 60 mm, with a thick fibrotic wall and extensive intracystic hemorrhage.Physicians should be aware that PRCH may mimic a cystic neoplasm, and that a large tumor size probably indicates intracystic hemorrhage.Surgical resection is a curative approach for PRCH.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pancreatic Disease Institute, Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.

ABSTRACT
Primary retroperitoneal cavernous hemangioma (PRCH) in an adult is extremely rare. We report on the diagnosis and treatment of a patient with PRCH with subtle clinical features and atypical findings on imaging scans. A 38-year-old man was admitted to hospital with a 5-day history of epigastralgia after alcohol drinking. Using various imaging methods, we found a giant cyst-like retroperitoneal mass compressing the surrounding organs. Surgical resection of the tumor was performed, and the mass was found to be a cavernous hemangioma measuring 90 × 80 × 60 mm, with a thick fibrotic wall and extensive intracystic hemorrhage. Physicians should be aware that PRCH may mimic a cystic neoplasm, and that a large tumor size probably indicates intracystic hemorrhage. Surgical resection is a curative approach for PRCH.

Show MeSH
Related in: MedlinePlus