Retroperitoneal Region Research Articles

Extraperitoneal pancreas transplantation: A technical note

Simultaneous pancreas-kidney transplantation is the best treatment of choice for patients with type 1 diabetes and end-stage renal failure. Despite the well-known technique of kidney transplantation, there is no general consensus on the most efficient technique for pancreas transplantation. Successful outcome of pancreas transplantation largely depends on the operating surgeon’s expertise and donor organ quality. However, donor organ quality is getting worse than before due to the worldwide epidemic of obesity. One aspect to improve is the surgical technique during which the organ is prepared and transplanted. In this article, we report a new surgical technique for pancreas transplantation to retroperitoneal region with enteric drainage by only a few centimeters of peritoneal violation and describe the possible advantages of this technique.

Diagnostic importance of clinicopathologic features and p16, CD34, MDM2 expression in differential diagnosis of adipocytic tumors.

The aim of this study was to investigate the immunohistochemical stain profiling of adipocytic tumors. From our archive files between the years of 2012-2018, excised, formalin-fixed and paraffin-embedded adipocytic tumors were retrospectively screened and 61 subjects were selected. The gender, age, tumor location and tumor diameter were evaluated. The cases were investigated in terms of p16, CD34, MDM2 expression and clinicopathological information. Of the 61 patients included in the study, we found that 2 had hibernoma, 4 had lipoblastoma, 14 had spindle cell lipoma (SCL), 10 had lipoma, 20 had atypical lipomatous tumor/well differentiated liposarcoma (ALT/WDL), and 11 had dedifferentiated liposarcoma (DDL). In terms of diameter, ALT/WDL and DDL were significantly different from the others (p=0.001, p=0.001, respectively). There was a significant difference between the groups according to the location (p=0.001). 35% (7/20) of ALT/WDLs were in the lower extremities (thighs) and 35% (7/20) were located in the retroperitoneal region. 70% of DDLs (7/11) were located in the retroperitoneum. When CD34 expression was evaluated among the groups, a significant difference was observed (p=0.001). CD34 was positive in 92.9% of SCL cases. p16 immunoreactivity was significantly different between the groups (p=0.001). p16 expression was observed in 50.5% of ALT / WDL cases and 79% of DDL cases. p16 and CD34 expression are valuable in the differential diagnosis of lipomatous tumors when radiological and clinical considerations do not help to differential diagnosis of adipocytic tumors. Level IV, Therapeutic Study.

Hydatid cyst disease in children: 10-years experience at two tertiary centers from Northeast Anatolia of Turkey

Aim: Hydatid cyst remains a significant health problem in endemic regions such as Turkey. It can be observed at any age, but the diagnosis is usually made at adulthood. The aim of this study was to investigate the epidemiological findings of hydatid cyst cases in the pediatric age group in Turkey. Material and Methods: The records of the patients who received the diagnosis of hydatid cyst in the pathology departments of Ataturk University Faculty of Medicine and Erzurum Regional Training and Research Hospital between 2009–2019 were analyzed retrospectively. Data such as age, sex, location, size and number of cysts of the cases diagnosed with hydatid cyst between 0–16 years of age were analyzed statisticall.Results: Of the 1072 cases diagnosed with hydatid cyst, 32.7% (n=351) were within the age range of 0–16 years, 57.8% (n=203) were male and 42.2% (n=148) were female, with a mean age of 10.8 years (SD: ± 3.5; min: 1, max: 16). In 86.3% (n=303) of the cases, the cyst was found to be located in a single organ, whereas it was located in two different organs in 13.7% (n=48) of the cases. Involvement of the liver and lung was observed in 54.4% (n=191) and 50.4% (n=177) of the cases, respectively. Less involvement was observed in brain (n=10), kidney (n=9), spleen (n=5), retroperitoneal region (n=4), omentum (n=2), nasal cavity (n=1), thoracolumbar region (n=1), tail of the pancreas (n=1) and ulna diaphysis (n=1). In all cases, the mean cyst size was measured to be 7.4 cm (SD: ± 2.9; min: 1.5, max: 17) based on the largest cyst size.Conclusion: Hydatid cyst is also common in the pediatric age group. Hydatid cyst has been found to be more common in males in the pediatric age group in Turkey, with its most common localization being in the liver and lung.

An accessory aberrant testicular artery branching from the inferior suprarenal artery: embryologic and genetic consideration

During routine educational dissection of a cadaver (61-year-old, male, white descent), multiple aberrant right testicular artery and veins were discovered. Detailed analysis of the abdominal vascular pattern showed that the accessory aberrant testicular artery branched off the right inferior suprarenal artery. It crossed the anterior pararenal space, gave several branches to the soft tissues of the posterior pararenal space, and descended towards the deep inguinal ring. The accessory aberrant testicular vein accompanied the aberrant artery and was drained by the right inferior suprarenal vein into the renal one. Two other testicular veins followed a typical course and opened into the inferior vena cava. The anatomical variability reported in this paper requires attention of the related specialists, as it may significantly complicate surgical and minimally invasive procedures on the organs of the retroperitoneal space and inguinal region. Thorough preoperative investigation regarding the variability of the vascular pattern should be conducted in patients considered for intervention on the adrenal gland, kidney, or testis.

Fatal Abdominal Stabbing: A Confusing Picture in Differentiating Homicide and Suicide

Background : Differentiating between homicide and suicide can be difficult and even impossible. In this report, we presented a fatal stabbing injury, which made a challenge in the verification of the manner of death. Case Report : A 45-year-old man was found dead in his workplace with a knife beside him. His mouth was closed with a scarf, his clothes were intact, and no evidence of a struggle was observed in the scene investigation. There was a vertical stab wound on the midline of the victim’s belly and his intestines were tangled out of the wound. In the autopsy, no defense wound was found. There was blood in the abdominal cavity and retroperitoneal region and several perforations were observed in the intestine and liver along the superficial wound. Painful death and torturous extraction of visceral organs resembled homicide, but nothing indicative of hostility and homicide was found by the forensic exploration and police investigation. Finally, the manner of death was assigned as suicide and the cause of death was a hemorrhagic shock as a result of sharp force injuries. Conclusion : This case represents a bizarre suicide, which is rare and highly suspicious of homicide. In such mysterious cases, the evidence of autopsy and crime scene and police investigation should be regarded to make a decision.

Unilateral double testicular arteries surround renal vein

Normally male rsquo s testicular arteries are originating from the abdominal aorta In this case we noted that testicular artery variations are related to renal and or aorta arteries The aim of this presentation was to evaluate the testicular arteries in male rsquo s reproductive system and their contribution with renal function in some disorders During routine dissection of abdomen rsquo s retroperitoneal region in a year old male cadaver we observed double variant testicular arteries with circle loop around left renal vein Anatomical variations of testicular and renal vessels must be considered to solve male genital and or renal disorders

Deep Vegetal Foreign Bodies in Cats: A Retrospective Study of 10 Cases.

The aim of this study was to describe the anatomic locations and treatments available for deeply located vegetal foreign bodies in cats. Ten cases of migrating vegetal foreign bodies (vFBs) requiring surgical removal are reported. The diagnoses of vFBs in the thoracic cavity (4/10), retroperitoneal space (2/10), and paratracheal region (1/10) were obtained by ultrasound examination; however, in the perineum or penile urethra (2/10) and peritoneum (1/10), the vFBs were found during surgery. Intraoperative ultrasound guidance helped remove vFBs from the retroperitoneal space and paratracheal tissues. Clinical signs resolved in 8 out of 10 cases, 1 out of 10 cases had recurrent draining fistula, and 1 out of 10 was euthanized for ethical reasons. The intrathoracic was the most common location in the present study, followed by retroperitoneal space and urethra/perineum. Ultrasound guidance was essential for the diagnosis and/or treatment of vFBs located in the thoracic, retroperitoneal, and cervical regions.

Brain ectopic tissue in sacrococcygeal region of a child, clinically mimicking sacrococcygeal teratoma: a case report

BackgroundMature brain heterotopic tissue in sacrococcygeal region is a very rare benign congenital abnormality of newborn. To date, only two cases of mature heterotopic brain tissue in the sacrococcygeal region is reported by literature. Heterotopic brain tissue in other areas such as lung, nose, face and retroperitoneal region are also rarely reported. Meanwhile, rather than brain heterotopic tissue in sacrococcygeal region, a case of adrenal gland heterotopic tissue in sacrococcygeal region also has been reported.Case presentationA 3.5 month-old male baby presented with history of sacrococcygeal mass since birth. Clinical examination of the child was good with no other problem. Sacrococcygeal region revealed an elevated round mass with no discharge. Computed tomography reported a large sacrococcygeal teratoma type-III arising from the sacrococcygeal region extending intra-abdominally to the level of L2 vertebral body. The mass was excised by the impression of sacrococcygeal teratoma (SCT). On gross examination, a gray-white irregular tissue fragment with 5 cm in greatest dimension was examined. Cut sections showed homogenous yellowish white appearance. Histological examination revealed solid fragments composed of mature neural tissue comprising glial cells and astrocytes with no other germ cell layer component.ConclusionMature brain heterotopic tissue in sacrococcygeal area is a rare benign disease. Two ectopic brain tissue in sacrococcygeal region were previously also reported. Sacrococcygeal teratoma is the most common congenital tumor, but this current rare case of heterotopic brain tissue in sacrococcygeal region should also be in the differential diagnosis.

Retroperitoneal Metastaz ile Bulgu Veren Burned-Out Seminomatöz Testiküler Tümör, Nadir Bir Olgu

"Burned-out testicular tumour" is extremely rare. Burned-out phenomenon describes partially or completely regressed germ cell tumours of the testes diagnosed after metastases in several parts of the body; including the mediastinum, cervical and axillary lymph nodes, retroperitoneal lymph nodes, and the retroperitoneal region. Physical examination of the testicles reveals non-specific findings. A 31-year-old male presented with abdominal and back pain. The physical examination findings were unremarkable. Imaging with computerized tomography showed a retroperitoneal mass. Excision of the retroperitoneal mass and the paraaortic, paracaval, and retroperitoneal lymph nodes was performed. The postoperative period was uneventfuland he was discharged on the postoperative 5thday. The postoperative pathological examination of the specimen reported a metastatic seminoma. Investigation of the underlying cause of a retroperitoneal mass in young adults requires including metastasis of burned-out germ cell tumours in the differential diagnosis. Further case reports on this rare type of tumour are required so that all potential risk factors will be defined and treatment protocols will be updated to optimize the management of the patients with burned-out germ cell tumours.

Giant Primary Retroperitoneal Serous Cystadenoma: A Rare Entity Mimicking Multiple Neoplastic and Nonneoplastic Processes.

Serous cystadenoma, often known as ovarian serous cystadenoma, is one of the common benign ovarian neoplasms. On the other hand, primary retroperitoneal serous cystadenoma is an extremely rare benign entity whose pathogenesis has not been well understood. Clinical presentation and symptomatology vary greatly and are highly dependent on the size and location of the lesion. Primary retroperitoneal serous cystadenomas are homogeneous, unilocular, thin-walled cystic masses. If they grow large enough, they tend to compress and deform adjacent organs, giving clinicians a misimpression of malignant pattern of behavior. Therefore, it is crucial to differentiate benign primary retroperitoneal serous cystadenomas from other epithelial and nonepithelial cystic lesions or masses involving retroperitoneal regions. Management-wise, complete cyst excision without rupture or spillage of the cyst contents is the recommended therapeutic method for primary retroperitoneal serous cystadenomas. This review will highlight the current knowledge on its pathogenesis and discuss its histopathologic features and differential diagnoses from the pathologist's point of view.

A retroperitoneal bronchogenic cyst mimicking a pancreatic lesion: a rare mass found in the retroperitoneal region

A retroperitoneal bronchogenic cyst mimicking a pancreatic lesion: a rare mass found in the retroperitoneal region

Neuroendocrine tumors from an unknown primary source: immunohistochemical and morphometric features

Neuroendocrine tumors belong to the group of favorable carcinomas of unknown primary location, but 90% of them are poorly differentiated by tumors that require immunohistochemistry to establish histogenesis of cells. The aim is to investigate the complex of morphological, morphometric and immunohistochemical characteristics of cases of neuroendocrine carcinoma without primary localization for improvement of verification algorithms of the primary source. Histological, morphometric and immunohistological characteristics of the biopsy material were established for 107 patients with neuroendocrine tumors without primary localization. The statistical analysis of the parameters of planes, perimeters and the circle coefficient of cells was performed in ImageJ and Microsoft Excel programs with the calculation of minimum, maximum, median (M), arithmetic mean (χ) and standard deviation (SD). The analysis of the distribution of observation groups was carried out according to the t-criterion. The most frequent localization of such neuroendocrine tumors is described in the retroperitoneal region, mediastinum and peripheral lymph nodes (40%), liver (25%) and bones (10–15%). With a decrease in the degree of differentiation of neuroendocrine tumors, the size of cell nuclei and the proliferation index in all studied groups significantly increased (all p <0.05).

Intraoperative radiation therapy for the treatment of recurrent retroperitoneal and pelvic tumors: a single-institution analysis

BackgroundPatients with recurrent retroperitoneal and pelvic region tumors often require multimodal therapies. Intraoperative radiation therapy (IORT) can deliver high-dose radiation to tumor beds, even if first-line external beam radiation therapy (EBRT) was administered. We evaluated local control (LC) and survival in patients receiving IORT for recurrent tumors.MethodsWe retrospectively analyzed 41 patients with isolated pelvic or retroperitoneal recurrences of colorectal, gynecological, or retroperitoneal primary tumors. Following salvage surgery, all patients underwent tumor bed IORT via electron beam or high dose rate brachytherapy. Isolated IORT (median dose: 15 Gy) was administered to patients who had received first-line EBRT; other patients received IORT (median dose 12 Gy) plus EBRT. Local (LF), regional (RF), and distant failures (DF) were evaluated, and the Kaplan–Meier method and log-rank test were used to evaluate and compare overall survival (OS) from the date of IORT.ResultsForty-one patients underwent 44 treatments, including 27 (61.3%) isolated IORT and 17 (38.7%) IORT and EBRT combination regimens. The median follow-up was 8.1 years (range: 4.4–11.7 years), and the 2, 5, and 8 year overall LC rates were 87.9, 64.0, and 49.8%, respectively. Regarding resection status, the respective 2, 5, and 8 year LC rates were 90, 76, and 76% for R0 resection and 75, 25, and 0% for R1 resection (p < 0.001). The 2, 5, and 8 year OS rates were 68, 43, and 26%, respectively. OS was better among patients with LC (p < 0.001). Twenty-four patients (58.5%) experienced a DF, and the 5 year OS rates for the patients with and without DF were 36 and 52%, respectively (p = 0.04).In a multivariate analysis, LF (p = 0,012) and recurrent retroperitoneal sarcoma (p = 0,014) were identified as significant predictors of worse OS. Thirteen patients (31%) developed clinically treatable complications related to IORT.ConclusionsMany patients achieve long-term OS and LC without significant morbidity after salvage surgery and IORT, especially in case of clear margins.

Laparoscopic Resection of An Extragastrointestinal Stromal Tumor in the Presacral Area

To show a surgical video in which a retroperitoneal extragastrointestinal stromal tumor was resected with the laparoscopic approach in the presacral area. A case report (Canadian Task Force classification III). The local ethics committee waived the requirement for approval. A very small proportion of extragastrointestinal stromal tumors (EGISTs) is located in the retroperitoneal region. There are insufficient data on the clinical and pathologic features and the long-term follow-up of these tumors [1]. There are a few cases reported in the presacral region in the literature. The gold standard treatment for EGISTs is complete surgical excision of the mass. If it is possible, en bloc excision with its surrounding tissue is very important [2]. A 53-year-old woman. The patient provided informed consent to use images and videos of the procedure. This is a step-by-step illustration for resection of a retroperitoneal EGIST in the presacral area. The patient was a 53-year-old, gravida 3, para 3 white woman. She presented with abdominal pain for 5 months. Magnetic resonance imaging showed a 4-cm diameter solid mass localized at the presacral area. Laboratory test results for tumor biomarkers were as follows: cancer antigen (CA) 125 = 40 U/mL (normal values <35 U/mL), CA 19-9 = 29 U/mL (normal values <37 U/mL), carcinoembryonic antigen = 2.1 ng/mL (normal values <3 ng/mL), and CA 15.3 = 18 U/mL (normal values <35 U/mL). Because of malignancy suspicion, gastroscopy and colonoscopy were performed and revealed no abnormality. The Papanicolaou smear and endometrial biopsy results were negative. After preparation of the patient, laparoscopy was performed. After placement of an 11-mm umbilical port and three 5-mm abdominal ports, the pelvis and abdomen were explored and revealed a 4-cm retroperitoneal mass in the presacral area. The peritoneum overlying the presacral mass was incised and the retroperitoneum explored. Given the proximity to the mass, left ureterolysis was performed. The mass was located on the left internal iliac vein and dissected carefully. The retroperitoneal attachments were resected, and the presacral mass was removed without any complications. In order not to widen the abdominal incisions, a posterior colpotomy was performed in the cul-de-sac at equal distances from the uterosacral ligaments. An Endobag (Covidien, Dublin, Ireland) was introduced through the 5-mm port site at the posterior colpotomy. The specimen was removed in the Endobag through posterior colpotomy. The procedure was performed without any complications. The patient had an uneventful postoperative course and was discharged home on postoperative day 2. Pathology revealed a 4-cm retroperitoneal EGIST with negative margins. Immunohistochemistry measurements revealed hematoxylin-eosin; CD117; S100 positivity; and CD34, CD68, desmin, and DOG1 negativity. The cell type was mixed (spindle and epithelioid type). The mitotic rate was 1 to 2/50 high-power fields. The patient has been disease free since the completion of surgery. Laparoscopic complete resection of the retroperitoneal EGIST in the presacral area is successfully performed in this patient. The patient presented by us is an example showing that minimally invasive procedures can be used in the treatment of this type of tumor in the presacral area. The key point in this operation is to control the relationship of vascular structures and a ureter with a tumor in every step to avoid any injury.

Abstract 2148: Image-guided catheter-based ultrasound thermal ablation of intramuscular and retroperitoneal sarcomas in the transgenic Oncopig cancer model

Abstract Soft-tissue sarcomas (STS) are aggressive, often lethal mesenchymal tumors that represent roughly 1% of adult cancers. The 5-year survival rate of STS has remained unchanged for decades at 50%, highlighting the need for more effective therapies. We are developing protocols and assessing the treatment efficacy of 3D spatially-registered real-time image-guided needle/catheter based ultrasound (CBUS) ablative thermal therapy in STS induced in the transgenic Oncopig cancer model (OCM). The transgenic Oncopig carries a Cre recombinase inducible transgene encoding KRASG12D and TP53R167H; both mutations commonly in human cancers. Cre recombinase induces expression of the transgenes and transformation of cells in culture and rapid and reproducible development of leiomyosarcomas when introduced into the muscle of oncopigs. The flexibility of the model allowed induction of sarcomas in two clinically relevant intramuscular (IM) sites in both the hind limb and retroperitoneal (RP) regions, to closely simulate human disease. We have previously shown that these Oncopig tumors present the same transcriptional hallmarks as human STS including altered TP53 signaling, Wnt signaling activation and evidence of epigenetic reprogramming. Initial acute studies revealed that the tumors could be successfully grown in the muscle reaching mean tumor volume of 19.76cm3 (RP, n= 8) and 25.12cm3 (IM, n=14) cm3 within two weeks following AdCre (5.0x108 to 1.0x109 PFU) injections. Tumors were then treated utilizing ultrasound image guidance combined with 3D EM tracking to place the applicator in the target region. Sectored tubular transducers were introduced through a small skin incision and used to precisely deliver thermal energy to the treatment region. Tumors were treated for 6-9 minutes at 7 watts acoustic power (10.2W/cm2). Thermocouples were inserted into the tumors monitored temperature throughout the treatment. Post-treatment analysis revealed that the mean induced lesion volume exceeded the actual tumor volume for both IM (43.41 cm3) and RP (22.87 cm3) tumors with mean peak temperatures reaching 64.56 ° C (IM) and 58.75 ° C (RP). The mean peak thermal dose (thermal equivalent minutes at 43 ° C - TEM43) accumulated for IM tumors was 3.70E+08, and 1.46E+06 for RP tumors. Histopathology analysis verified that treatment areas reached past tumor margins using single applicator configuration. This study clearly demonstrates that the Oncopig is a suitable model in size and clinically relevant tumor type for evaluation of ultrasound ablation instrumentation. In addition, these STS treatment protocols can reliably and accurately target and treat tumor volumes plus surrounding margins. Future work will include monitoring of treatment lesions for up to 3 months post ablation. Funded by NIH 5R21CA195433 Citation Format: Laurie A. Rund, Goutam Ghoshal, Emery Williams, Paul Neubauer, Lance Frith, R Tamas Heffter, Patrick Roady, Lawrence B. Schook, E Clif Burdette. Image-guided catheter-based ultrasound thermal ablation of intramuscular and retroperitoneal sarcomas in the transgenic Oncopig cancer model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2148.

Plasma cell‐free DNA quantification is highly correlated to tumor burden in children with neuroblastoma

To evaluate plasma cell‐free DNA (cfDNA) as a promising biomarker for neuroblastoma (NB) tumor burden. Seventy‐nine eligible patients with newly diagnosed NB were recruited from Beijing Children's Hospital between April 2016 and April 2017. Additionally, from September 2011 to June 2017, 79 patients with stable NB were evaluated with a median follow‐up time of 21 months. Approximately 2 mL of peripheral blood was drawn upon enrollment, and plasma cfDNA levels were measured via quantitative polymerase chain reaction (qPCR). Total cfDNA analysis was performed using the long interspersed nuclear element 1 (LINE‐1) 79 bp fragment, and DNA integrity was calculated by the ratio of the LINE‐1 300 bp fragment to the LINE‐1 79 bp fragment. A total of 79 NB patients with a median age of 36 months comprised the group of newly diagnosed NB patients. The main primary tumor site was the retroperitoneal and adrenal region (81%). Three or more metastatic sites were found in 17.7% of patients. Stable NB patients older than 18 months comprised 98.7% of the stable NB patients. Neuron‐specific enolase (NSE), lactate dehydrogenase (LDH), and cfDNA levels were dramatically increased in the newly diagnosed NB patients and significantly different from those in the stable NB patients. Moreover, the concentration of cfDNA was much higher in patients with larger tumors. By analyzing the area under the receiver operator characteristic (ROC) curve (AUC), the areas of total cfDNA, NSE, and LDH levels were 0.953, 0.929, and 0.906, respectively. The sensitivity and specificity data clarified that the level of circulating cfDNA in plasma can be considered as a reliable biomarker for describing tumor load in NB. The plasma cfDNA concentration was as good as the levels of LDH and NSE to discriminate the tumor burden in children with NB.

Dyspnea caused by a giant retroperitoneal liposarcoma: A case report.

Liposarcomas are the most common soft tissue tumors with various histological subtypes. They usually appear in the retroperitoneal region of the abdomen, but their symptomatology remains unclear and their diagnosis, as well as treatment challenging. A case of a 55-year-old female patient with dyspnea and light diffuse abdominal pain caused by a giant retroperitoneal liposarcoma is presented. The patient had an unremarkable medical history, while the computed tomography scan revealed a large mass at the right portion of the abdomen, with its upper limits to the lower edge and the gate portion of the liver. The mass was in contact with the right kidney, the inferior vena cava and the right renal vein, causing mild dilation of the right kidney pelvis. Without any evidence of intra-abdominal metastases, the tumor was surgically resected. The histological analysis of the tumor revealed a well-differentiated liposarcoma. The patient had an uneventful recovery and was discharged on the 10th postoperative day. Until today (4 years later) she remains asymptomatic, without any signs of recurrence. The retroperitoneal liposarcoma is a clinical entity with unclear clinical symptoms and the physician should consider including it in the differential diagnosis of a majority of symptoms, such as dyspnea.

HOTAIR gene polymorphisms contribute to increased neuroblastoma susceptibility in Chinese children.

Neuroblastoma is the most frequently diagnosed extracranial solid tumor in children. Previous studies have shown that single-nucleotide polymorphisms in some genes are associated with the risk of multiple cancers, including neuroblastoma. Although Hox transcript antisense intergenic RNA (HOTAIR) gene polymorphisms have been investigated in a variety of cancers, to the authors' knowledge the relationships between HOTAIR gene polymorphisms and neuroblastoma susceptibility have not been reported to date. The objective of the current study was to evaluate the correlation between HOTAIR gene polymorphisms and neuroblastoma risk in Chinese children. The authors genotyped 6 polymorphisms (rs920778 A>G, rs12826786 C>T, rs4759314 A>G, rs7958904 G>C, rs874945 C>T, and rs1899663 C>A) of the HOTAIR gene in 2 Chinese populations including 393 neuroblastoma cases and 812 healthy controls. The strength of the associations was evaluated using odds ratios and 95% confidence intervals. Further stratification analyses were conducted to explore the association between the HOTAIR gene polymorphisms rs12826786 C>T, rs874945 C>T, and rs1899663 C>A with neuroblastoma susceptibility in terms of age, sex, clinical stage of disease, and sites of origin. The authors found that the rs12826786 C>T (P =.013), rs874945 C>T (P =.020), and rs1899663 C>A (P =.029) polymorphisms were significantly associated with increased neuroblastoma risk. In stratification analyses, these associations were more predominant in females and among patients with tumor in the retroperitoneal region or mediastinum. The remaining 3 polymorphisms were not found to be related to neuroblastoma susceptibility. The results of the current study verified that HOTAIR gene polymorphisms are associated with increased neuroblastoma risk and suggest that HOTAIR gene polymorphisms might be a potential biomarker for neuroblastoma susceptibility. Cancer 2018;124:2599-606. © 2018 American Cancer Society.

Unusual Combination Of Vascular Variations In The Retroperitoneal Region. A Morphological Study

Background: Blood supply of kidney and gonads is characterized by the presence of variations, which are usually silent and unnoticed until they are found by retroperitoneal surgery, radiologic examination or necropsy. Multiple renal vessels are no longer relative contraindication for laparoscopic donor nephrectomy, however of their presence may help avoid possible complication on a patient with these variations. The purpose of this morphological study was to analyze the frequency of supernumerary renal and testicular vessels and describe an unusual combination of vascular variations in the retroperitoneal region.&#x0D; Methods and Findings: A total of 18 cadavers with different age group and 10 visceral blocks were used for the study in the Morphology Laboratory of the University of Pamplona. Multiple anatomical variations bilateral of testicular vessels and renal were found during routine dissection in a 65-year-old male cadaver. The variations found were: bilateral presence of three renal arteries and three renal veins. The three left renal arteries are divided and gave rise to seven branches: the left main renal artery originates two branches; the upper branch originates four branches and the lower branch originates one branch. Retro-aortic left renal vein. Three left testicular artery and double right testicular artery all originating from accessory renal arteries.&#x0D; Conclusions: Awareness of renal and testicular vessels anomalies is essential for decreasing the rate of accidental injuries in surgical procedures in the retroperitoneal region as well as aid in diagnosis of diseases associated with vascular variation in the posterior abdomen. An understanding of the morphology of renal and testicular vessels is necessary in uroradiology, Doppler imaging and computed tomography studies.

Retroperitoneal malignant peripheral nerve sheath tumor

Primary retroperitoneal neoplasms are a rare entity and account for 0.1%–0.2% of all malignancies. In addition, only 1% of malignant peripheral nerve sheath tumors (MPNSTs) occur in retroperitoneal region. Herein, we report a case of retroperitoneal peripheral nerve sheath tumor in a 50-year-old man who presented with right lower limb pain. On physical examination, an abdominal mass was palpable. Computed tomography of abdomen with contrast, showed a large, lobulated mass, in the right paravertebral region extending to the middle area of abdomen and pelvis. The patient underwent exploratory laparotomy and mass excision. Histopathological examination was consistent with “MPNSTs.” This case report emphasizes that, although rare, MPNSTs may arise from retroperitoneal region. They have varied clinical presentations, and combination of microscopic, radiological, and immunohistochemical analysis is needed for diagnosis of MPNSTs.