Abstract
BackgroundRetroperitoneal tumors (RTs) develop insidiously and are generally seen as large masses, and 50% of RTs are larger than 20 cm at the time of diagnosis. In this article, we share our experience of 5 years of surgical management of RTs.MethodsWe evaluated 28 RT cases operated on in three education hospitals in Turkey from January 2008 onwards, with regard to patients’ demographic characteristics, complaints, weight loss figures, the location and size of the tumor, blood transfusion, intra-operational time, metastases (in malignant cases), additional organ resection, histological grade, local recurrences, average life expectancy, and post-operative treatment methods.ResultsThe mean age of the patients was 49 years (range, 18 to 78 years). Twenty (71.43%) were female, and 8 (28.57%) were male. The primary complaint was abdominal pain in 18 patients (64.28%). CT scans were performed in 17 (61%) patients, 10 (35.4%) underwent abdominal MR imaging, and 1 (3.6%) underwent both abdominal CT and abdominal MR imaging. A mass was palpated in the pelvis (suprapubic region) in seven (25%) of the patients during physical examination. The largest tumors were detected in the left lumbar area. The mean tumor size was 12.78 cm (range, 2 to 30 cm). The mean intra-operational time was 192 min (range, 70 to 380 min). The mean hospitalization period was 11 days (range, 8 to 23 days). Seven (25%) patients were reported to have benign tumors, while 21 (75%) were reported to have malignant tumors. The most frequently seen malignant pathology was liposarcoma (eight cases; 38.09%) followed by leiomyosarcoma (five cases; 23.8%) and malignant fibrous histiocytoma (four cases; 19.04%). The earliest local recurrence was detected in the 12th month and the latest in the 28th month. A total of 11 (52.3%) of the total of 21 malignant cases experienced local recurrence within 3 years. The 3-year average life expectancy was 85.7% in the 18 malignant cases.ConclusionsDue to the low response rate of all but two types of RT to chemotherapy, the best remaining treatment option is surgery with wide resection margins, whereby all macroscopic traces of tumor are removed.
Highlights
Retroperitoneal tumors (RTs) develop insidiously and are generally seen as large masses, and 50% of RTs are larger than 20 cm at the time of diagnosis
Twenty-one (75%) of the RTs were malignant, while 7 (25%) were benign (Figures 1 and 2), and the most frequent pathologies were liposarcoma in 8 (38.1%) patients, leiomyosarcoma in 5 (23.8%), malignant fibrous histiocytoma in 5 (23.8%), and malignant paraganglioma in 1 (4.76%) patient who had generalized intra-abdominal metastasis in the sixth month (Table 2)
A mass was palpated in the pelvis of seven (25%) patients during physical examination, with the second most frequent area of mass palpation in the left upper quadrant in six (21.4%) patients
Summary
Retroperitoneal tumors (RTs) develop insidiously and are generally seen as large masses, and 50% of RTs are larger than 20 cm at the time of diagnosis. We share our experience of 5 years of surgical management of RTs. Retroperitoneal tumors (RTs) commonly present with abdominal distention and palpable mass. Retroperitoneal tumors (RTs) commonly present with abdominal distention and palpable mass In many cases, they are detected as a result of imaging techniques performed to investigate unrelated issues. RTs develop insidiously and are generally seen as large masses; 50% of RT is larger than 20 cm at the time of diagnosis. High histological grade, inoperability due to invasion into vital organs, and a positive surgical border can be listed among the most significant factors affecting survival. The average life expectancy for patients with high-grade RTs is 20 months, while for low-grade RTs, it is 80 months; RTs larger
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