• Title/Summary/Keyword: retroperitoneal

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Clinical Presentation of Paraganglioma in Orthopaedics - Report of Two Cases - (정형외과 영역에서의 부신경절종의 임상 양상 - 2례 보고 -)

  • Lee, Sang-Lim;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo;Kim, Hyung-Ho;Kim, June-Hyuk
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.94-99
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    • 2005
  • Paraganglioma is a neoplasm consisting of sympathetic neuroendocrine cells, which arise from neural ectoderm of extra-adrenal paraganglia. It often occurs in thyroid, carotid body, mediastinum, lung, duodenum, the retroperitoneal area and periaortic area. Malignant paraganglioma is defined not by the histological diagnosis, but by spread to regional lymph nodes or distant metastasis. Rare bone metastasis mostly occurs in the base of skull or spine, and even it rarely metastasizes to pelvis or femur. We would like to report two cases of paraganglioma; one in the subcutaneous fat layer that was mistaken for a vascular tumor, and the other in the retroperitoneal space with early bone metastasis.

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Two-cases of Reduction of Side Effects of Surgery and Radiation Therapy in Retroperitoneal Liposarcoma Treated with Traditional Korean Medicine (한방 치료로 수술 및 방사선 치료 후 부작용 완화를 이룬 후복막 지방육종 환자 2례의 보고)

  • Bae, Kyeore;Kim, Ji-Hye;Park, Ji-Hye;Park, So-jung;Kang, Hwi-joong;Cho, Chong-kwan;Yoo, Hwa-seung
    • Journal of Korean Traditional Oncology
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    • v.20 no.2
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    • pp.37-49
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    • 2015
  • Objectives : Retroperitoneal liposarcoma (RPS) is a rare solid tumor and has a high recurrence rate after surgery. New complementary and alternative medicine is required to manage symptoms of RPS and side effects of surgery, chemotherapy and radiation therapy. The purpose of this case report is to report two cases of reduction of side effects of surgery and radiation therapy in RPS treated with Wheel Balanced Therapy (WBT) which is a traditional Korean medicine treatment program for patients with cancer. Methods : Two patients with RPS were treated with WBT. Each of patients received personalized WBT schedule including acupuncture. The changes in clinical and laboratory findings were evaluated. Results : The symptoms of patients were improved after about 2 weeks hospitalization. Conclusions : This case report suggests that WBT has a potential to treat side effects of surgery and radiation therapy in patients with RPS. Further rigorous studies are necessary to investigate the therapeutic effects of WBT on RPS.

Computed Tomography Manifestations of Histologic Subtypes of Retroperitoneal Liposarcoma

  • Lu, Jing;Qin, Qin;Zhan, Liang-Liang;Yang, Xi;Xu, Qing;Yu, Jing;Dou, Li-Na;Zhang, Hao;Yang, Yan;Chen, Xiao-Chen;Yang, Yue-Hua;Cheng, Hong-Yan;Sun, Xin-Chen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6041-6046
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    • 2014
  • Objective: Liposarcoma (LPS) is the most common soft tissue sarcoma and accounts for approximately 20% of all mesenchymal malignancies, often occurring in deep soft tissue of retroperitoneal space. Accurate preoperative diagnosis is therefore necessary. We explored whether computed tomography (CT) could be used to differentiate between the various types of retroperitoneal liposarcoma (RPLS). Method: Forty-seven cases of RPLS, diagnosed surgically and histologically, were analyzed retrospectively. CT features were correlated with postoperative pathological appearance. Results: The study radiologist identified 29, 11, 2, 2 and 3 RPLS as atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL), dedifferentiated liposarcoma (DDL), myxoid/round cell liposarcoma (ML/RCL), pleomorphic liposarcoma (PL) and mixed-type liposarcoma. Analysis of CT scans revealed the following typical findings of the different subtypes of RPLS: ALT/WDL was mainly visible as a well-delineated fatty hypodense tumor with uniform density and integrity margin; DDL was marked by the combination of focal nodular density and hypervascularity. ML/RCL, PL and mixed liposarcoma showed malignant biological behaviour and CT findings need further studies. Conclusions: CT scanning can reveal important details including internal components, margins and surrounding tissues. Based on CT findings, tumor type can be roughly evaluated and biopsy location and therapeutic scheme guided.

A Case of Pulmonary and Retroperitoneal Lymphangioleiomyomatosis (폐와 후복강에 발생한 림프관평활근종증 1예)

  • Kwak, Nam-Ju;Park, Nam-Gu;Kim, He-Young;Choe, Gi-Won;Eom, Je-Ho;Kim, Dong-Un;Cho, Meong-Chan;Yun, Se-Jin;Kim, Sung-Taek;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.600-604
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    • 1995
  • Lymphangioleiomyomatosis, a rare disease in women of childbearing age, is the result of benign nodular hypertrophy of the smooth muscle of the lypmhatics and other tissues of the abdomen and thorax. We report a 36-years-old woman with pulmonary and retroperitoneal lymphangioleiomyomat.osis who responded with hormone treatment. She developed vaginal pruritis and a pelvic ultraound was done given her significant past medical history. Ultrasound examination demonstrated a large mass in the right side of her pelvis. Therefore she was admitted to St. Michael's Hospital in Toronto for laparoscopy. Result of cytology was to be consistent with the diagnosis of retroperitoneal lymphangioleiomyomatosis. High resolution CT sacn of the thorax demonstrated multiple small cystic lesions, without associated nodularity compatible with a diagnosis of pulmonary lymphangioleiomyomatosis. She has been taking Provera tablets 100mg po tid since Dec. 15, 1993. We have given her a prescription for Depo provera 500mg IM monthly since she came back to Korea. and made arrangements for regular follow up monthly. We performed chest X-ray, CT of chest(high resolution), abdomen and pelvis, pulmonary function tests and arterial blood gas analysis. Chest X-ray and CT findings showed no significant change since July. 20, 1993.

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The Evaluation of Optimized Inversion-Recovery Fat-Suppression Techniques for T2-Weighted Abdominal MR Imaging : Preliminary report (복부의 T2강조 영상에서 지방소거기법의최적의 평가)

  • Lee, Da-Hee;Goo, Eun-Hoe
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.1
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    • pp.31-35
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    • 2012
  • To test the real image quality of a spectral attenuated inversion-recovery (SPAIR) fat-suppression (FS) techniquein clinical abdominal MRI by comparison to turbo spin echo inversion-recovery (TSEIR) fat-suppression (FS) technique. 3.0T MRI studies of the abdomen were performed in 30 patients with liver lesions (hemangiomas n: 15; HCC n: 15). T2W sequences were acquired using SPAIR TSEIR. Measurements included retroperitoneal and mesenteric fat signal-to-noise (SNR) to evaluate FS; liver lesion contrast-to-noise (CNR) to evaluate bulk water signal recovery effects; and bowel wall delineation to evaluate susceptibility and physiological motion effects. SPAIR-TSEIR images produce significantly improved FS and liver lesion CNR. The mean SNR of the retroperitoneal and mesenteric fat for SPAIR were 20.5, 10.2 and TSEIR were 43.2, 24.1 (P<0.05). SPAIR-TSEIR images produced higher CNR for both hemangiomas CNR 164.88 vs 126.83 (P<0.05) and metastasis CNR 75.27 vs 53.19 (P<0.05). Bowel wall visualization was significantly improved using in both SPAIR-TSEIR (P< 0.05). The real image quality of SPAIR was better than over conventional TSEIR FS on clinical abdominal MRI scans.

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Cytologic Features of Metastatic Retroperitoneal Seminoma - A Case Report - (후복막강에 전이한 정상피종의 세포학적 소견 - 1예 보고 -)

  • Kwon, Mi-Seon;Seo, Eun-Joo;Kim, Young-Shin;Kang, Chang-Suk;Shim, Sang-In
    • The Korean Journal of Cytopathology
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    • v.6 no.1
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    • pp.71-75
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    • 1995
  • A fine needle aspiration biopsy specimen of a retroperitoneal mass in a 26-year-old man who had had an orchiectomy for seminoma was submitted for cytologic evaluation. Cytologic features of the specimen included uniform neoplastic cells found singly or in groups of several cells intermingled with lymphocytes in a characteristic foamy, lacelike background. These cells varied from 10 to 20 m in diameter. The nuclei were round to ovoid with fine or reticular chromatin and one or more prominent nucleoli. The poorly defined cytoplasm stained pale-blue or blue with cytoplasmic vacuoles. The cytologic appearance was consistent with seminoma. Documented reports of the cytological appearance of seminoma are rare. The diagnosis of primary gonadal seminoma by fine needle aspiration biopsy is probably not indicated since the treatment of a primary gonadal tumor, regardless of its histogenesis, requires surgical resection. However, fine needle aspiration biopsy is extremely valuable in the diagnosis of extragonadal as well as metastic and recurrent seminoma.

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Left Common Femoral to Right Common Iliac Venous Bypass Through a Retroperitoneal Exposure

  • Cuen-Ojeda, Cesar;Bobadilla-Rosado, Luis O;Garcia-Alva, Ramon;Arzola, Luis H.;Anaya-Ayala, Javier E.;Hinojosa, Carlos A.
    • Vascular Specialist International
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    • v.34 no.4
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    • pp.117-120
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    • 2018
  • The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

Immunoglobulin G4-Related Aortitis of the Abdominal Aorta

  • Choi, Jae Won;Choi, Jun Young;Go, Kyung Hyuk;Cheon, Yun Hong;Kim, Jong Woo;Lee, Chung Eun;Park, Hyun Oh
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.239-242
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    • 2019
  • Noninfectious aortitis, inflammatory abdominal periaortitis, and idiopathic retroperitoneal fibrosis are chronic inflammatory diseases with unclear causes. Recent studies have shown that some cases of aortitis are associated with immunoglobulin G4 (IgG4)-related systemic disease. Herein, we report a case of IgG4-related aortitis (IgG4-RA) that was diagnosed after surgery. Our patient was a 46-year-old man who had experienced abdominal pain for several weeks. Preoperative evaluations revealed an area of aortitis on the infrarenal aorta. He underwent surgery, and histological examination resulted in a diagnosis of IgG4-RA.

What Is the Ideal Entry Point for Transforaminal Endoscopic Lumbar Discectomy?

  • Lee, Jong Un;Park, Ki Jeoung;Kim, Ki Hong;Choi, Man Kyu;Lee, Young Hwan;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.614-622
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    • 2020
  • Objective : The method of approach during transforaminal endoscopic lumbar discectomy (TELD) has been the subject of repeated study. However, the ideal entry point during TELD has not been studied in detail. Therefore, this study investigated the ideal entry point for avoiding complications using computed tomography (CT) scans obtained from patients in the prone position. Methods : Using CT scans obtained from patients in the prone position, we checked for retroperitoneal or visceral violations and measured the angles of approach with five conventional approach lines drawn on axial CT scans at each disc space level (L2-3, L3-4, and L4-5). We also determined the ideal entry point distance and approach angles for avoiding retroperitoneal or visceral violations. Correlation analysis was performed to identify the patient characteristics related to the ideal entry point properties. Results : We found that the far lateral approach at the L2-3 level resulted in high rates of visceral violation. However, rates of visceral violation at the L3-4 and L4-5 levels were remarkably low or absent. The ideal angles of approach decreased moving caudally along the spine, and the ideal entry point distances increased moving caudally along the spine. Weight, body mass index (BMI), and the depth of the posterior vertebral line from the skin were positively associated with the distance of the ideal entry point from the midline. Conclusion : We reviewed the risk of the extreme lateral approach by analyzing rates of retroperitoneal and visceral violations during well-known methods of approach. We suggested an ideal entry point at each level of the lumbar spine and found a positive correlation between the distance of the entry point to the midline and patient characteristics such as BMI, weight, and the depth of the posterior vertebral line from the skin.

Laparoscopic Retroperitoneal Nephroureterectomy is a Safe and Adherent Modality for Obese Patients with Upper Urinary Tract Urothelial Carcinoma

  • Matsumoto, Kazumasa;Hirayama, Takahiro;Kobayashi, Kentaro;Hirano, Syuhei;Nishi, Morihiro;Ishii, Daisuke;Tabata, Ken-ichi;Fujita, Tetsuo;Iwamura, Masatugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3223-3227
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    • 2015
  • Objective: We evaluated the association of body mass index (BMI) with perioperative outcomes in patients who underwent laparoscopic or open radical nephroureterectomy. Materials and Methods: This retrospective single-center study included 113 patients who had been diagnosed with upper urinary tract cancer from January 1998 to June 2013 and were treated with laparoscopic nephroureterectomy (Lap group, n=60) or open nephroureterectomy (Open group, n=53). Laparoscopic nephroureterectomy was performed via a retroperitoneal approach following an open partial cystectomy. The two surgical groups were stratified into a normal-BMI group (<25) and a high-BMI group ($BMI{\geq}25$). The high-BMI group included 27 patients: 13 in the Lap group and 14 in the Open group. Results: Estimated blood loss (EBL) in the Lap group was much lower than that in the Open group irrespective of BMI (p<0.01). Operative time was significantly prolonged in normal-BMI patients in the Lap group compared to those in the Open group (p=0.03), but there was no difference in operative time between the Open and Lap groups among the high-BMI patients. Multivariate logistic regression analysis of the data for all the cohorts revealed that the open procedure was a significant risk factor for high EBL (p<0.0001, hazard ratio 8.02). Normal BMI was an independent predictor for low EBL (p=0.01, hazard ratio 0.25). There was no significant risk factor for operative time in multivariate analysis. There were no differences in blood transfusion rates or adverse event rates between the two surgical groups. Conclusions: Laparoscopic radical nephroureterectomy via a retroperitoneal approach can be safely performed with significantly reduced EBL even in obese patients with upper urinary tract cancer.