We report here a case of an inflammatory myofibroblastic tumor in the retroperitoneum, which mimicked a germ cell tumor of the undescended testis. A 75-year-old healthy man presented with a palpable abdominal mass. On...We report here a case of an inflammatory myofibroblastic tumor in the retroperitoneum, which mimicked a germ cell tumor of the undescended testis. A 75-year-old healthy man presented with a palpable abdominal mass. On the computed tomography image, there was large, well-defined soft tissue mass in the left side of the retroperitoneum, and there was no visible left testis or seminal vesicle. After contrast enhancement, the mass appeared to be relatively homogeneous, considering its large size. With ultrasonography, it appeared as a well-defined, hypoechoic mass with intratumoral vascularity. This solid mass was surgically diagnosed as an inflammatory myofibroblastic tumor.展开更多
Beckwith-Wiedemann syndrome(BWS) is an overgrowth syndrome associated with increased risk to develop malignancies including adrenocortical carcinoma. Ovarian thecal metaplasia of the adrenal gland is a rare tumorlike ...Beckwith-Wiedemann syndrome(BWS) is an overgrowth syndrome associated with increased risk to develop malignancies including adrenocortical carcinoma. Ovarian thecal metaplasia of the adrenal gland is a rare tumorlike mesenchymal lesion in BWS patients that lacks detailed radiological description. We report a 17-yearold female patient with BWS, associated with bilateral Wilms tumor, hepatic hemangiomatosis, pancreatic neuroendocrine tumor, and a phyllodes tumor of the right breast. Surveillance abdominal ultrasound identified a right adrenal mass that was further characterized by computed tomography and magnetic resonance imaging. Radiologically, this mass displayed features that overlap with adrenocortical carcinoma and pheochromocytoma but after pathological examination this proved to be an ovarian thecal metaplasia of the adrenal gland. Adrenal masses in BWS should raise the suspicion for adrenocortical carcinoma though other adrenal tumors including ovarian thecal metaplasia can be seen in these patients.展开更多
Background Benign and malignant primary retroperitoneal tumors （RT） have different pathological manifestations,and overlapping imaging characteristics.This study aimed to evaluate the value of computed tomography ...Background Benign and malignant primary retroperitoneal tumors （RT） have different pathological manifestations,and overlapping imaging characteristics.This study aimed to evaluate the value of computed tomography （CT） for differentiating benign from malignant RT.Methods One hundred and ninety-four patients with clinical and radiographic data were evaluated retrospectively following surgical resection of primary RT.There were 38.1％ （n=74） benign lesions and 61.9％ （n=120） malignant lesions.Categorical variables were tested with a chi-square test or Fisher＇s exact test for the diagnostic indexes and sensitivity and specificity of CT characteristics.Results In univariate analysis,the differences in ill-defined margins,irregular surfaces,long diameter ＞6.75 cm,short diameter ＞6.25 cm,and solid or mixed texture had statistical significance; the sensitivity and specificity were 44.2％ and 91.9％,70.0％ and 62.2％,68.8％ and 60.7％,59.7％ and 74.2％,87.5％ and 35.1％,respectively.In multivariate analysis,a combination of all the above indexes was the best model for differentiating malignant tumors,resulting in the most accurate diagnosis of malignancies with a sensitivity of 77.2％ and a specificity of 81.1％ （P＜0.0001） when the score was 4.The differences in other findings including CT attenuation,number,and calcification had no statistical significance.The unique characteristics included the spotted enhancement （mottled high density）in schwannoma （P＜0.0001）,adipose tissue in liposarcoma （P＜0.0001）and paravertebral location in neurogenic tumors （P＜0.0001）.Conclusions More accurate differential diagnosis of primary RT can be made through comprehensive analysis of the combined diagnostic indexes of CT.Some specific characteristics of CT can assist in preoperative planning.展开更多
文摘We report here a case of an inflammatory myofibroblastic tumor in the retroperitoneum, which mimicked a germ cell tumor of the undescended testis. A 75-year-old healthy man presented with a palpable abdominal mass. On the computed tomography image, there was large, well-defined soft tissue mass in the left side of the retroperitoneum, and there was no visible left testis or seminal vesicle. After contrast enhancement, the mass appeared to be relatively homogeneous, considering its large size. With ultrasonography, it appeared as a well-defined, hypoechoic mass with intratumoral vascularity. This solid mass was surgically diagnosed as an inflammatory myofibroblastic tumor.
文摘Beckwith-Wiedemann syndrome(BWS) is an overgrowth syndrome associated with increased risk to develop malignancies including adrenocortical carcinoma. Ovarian thecal metaplasia of the adrenal gland is a rare tumorlike mesenchymal lesion in BWS patients that lacks detailed radiological description. We report a 17-yearold female patient with BWS, associated with bilateral Wilms tumor, hepatic hemangiomatosis, pancreatic neuroendocrine tumor, and a phyllodes tumor of the right breast. Surveillance abdominal ultrasound identified a right adrenal mass that was further characterized by computed tomography and magnetic resonance imaging. Radiologically, this mass displayed features that overlap with adrenocortical carcinoma and pheochromocytoma but after pathological examination this proved to be an ovarian thecal metaplasia of the adrenal gland. Adrenal masses in BWS should raise the suspicion for adrenocortical carcinoma though other adrenal tumors including ovarian thecal metaplasia can be seen in these patients.
文摘Background Benign and malignant primary retroperitoneal tumors （RT） have different pathological manifestations,and overlapping imaging characteristics.This study aimed to evaluate the value of computed tomography （CT） for differentiating benign from malignant RT.Methods One hundred and ninety-four patients with clinical and radiographic data were evaluated retrospectively following surgical resection of primary RT.There were 38.1％ （n=74） benign lesions and 61.9％ （n=120） malignant lesions.Categorical variables were tested with a chi-square test or Fisher＇s exact test for the diagnostic indexes and sensitivity and specificity of CT characteristics.Results In univariate analysis,the differences in ill-defined margins,irregular surfaces,long diameter ＞6.75 cm,short diameter ＞6.25 cm,and solid or mixed texture had statistical significance; the sensitivity and specificity were 44.2％ and 91.9％,70.0％ and 62.2％,68.8％ and 60.7％,59.7％ and 74.2％,87.5％ and 35.1％,respectively.In multivariate analysis,a combination of all the above indexes was the best model for differentiating malignant tumors,resulting in the most accurate diagnosis of malignancies with a sensitivity of 77.2％ and a specificity of 81.1％ （P＜0.0001） when the score was 4.The differences in other findings including CT attenuation,number,and calcification had no statistical significance.The unique characteristics included the spotted enhancement （mottled high density）in schwannoma （P＜0.0001）,adipose tissue in liposarcoma （P＜0.0001）and paravertebral location in neurogenic tumors （P＜0.0001）.Conclusions More accurate differential diagnosis of primary RT can be made through comprehensive analysis of the combined diagnostic indexes of CT.Some specific characteristics of CT can assist in preoperative planning.
