A rare cause of benign retroperitoneal mass mimicking adnexial malignancy in a postmenopausal woman: retroperitoneal fibroma

Abstract

© 2014 Akpak et al; licensee Herbert Publications Ltd. This is an Open Access article distributed under the terms of Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence We read with great interest the article by G Bassi et al., [1] in which the authors presented a case named “An incidental retroperitoneal solitary fibrous tumor”. They mentioned about the clinicopathological characteristics of retroperitoneal solitary fibrous tumor and analyse the diagnosis of retroperitoneal fibrosis. Unfortunately, there are only a few cases of retroperitoneal fibroma reported in the literature. When we search “retroperitoneal fibroma” in PubMed we found only five literatures in english about this rare condition. The total number of reported cases has been fewer than thirteen. Therefore there is limited information about the retroperitoneal fibromas. Fibromas are stromal tumours composed of spindle, oval or round collagen-producing cells that resemble fibroblasts [2]. Herein, we present a patient with pelvic retroperitoneal fibroma which was confirmed histopathologically following surgery. Imaging findings of the tumor mimicked an adnexial mass preoperatively. A 54-year-old postmenopausal multiparous woman presented us with a complaint of lower abdominal pain, dyspareunia and urinary retention for 3 years. The patient had a history of total abdominal hysterectomy operation 16 years ago. A solid, movable mass was noted in the middle and left lower quadrant of abdomen by abdominopelvic examination. Transvaginal ultrasonography revealed a smooth surfaced solid tumoral mass with calcific degeneration measuring 86x82x88 mm located in the middle region near the vagina cuff, occupying the left adnexial area (Figure 1A). We did not see ureteral obstruction or ectasia of renal pelvis by abdominal ultrasonography. Laboratory examinations including tumor markers (AFP, CA 125, CEA, CA199, CA 15-3) were unremarkable. Pelvic magnetic resonance imaging demonstrated about 8x8 cm in size pelvic solid mass with heterogeneous internal structure, showing no significant enhancement, located in the middle and left adnexial region (Figures 1B and 1C). However, a malignant lesion could not be ruled out. One month after the initial examination, laparotomy *Correspondence: yasamaster@gmail.com