Bakker R F R, Stoot J H M B, Blok P, Merkus J W S
Department of Surgery, Haga Hospital, location Red Cross, Sportlaan 600, 2566 MJ The Hague, The Netherlands.
Virchows Arch. 2007 Oct;451(4):853-7. doi: 10.1007/s00428-007-0479-3. Epub 2007 Aug 10.
Primary retroperitoneal cystadenomas are extremely rare. This is the first report in literature to describe a primary retroperitoneal cystadenoma with a sarcoma-like mural nodule. A 45-year-old woman complained of a left-sided abdominal mass. A computed tomography scan revealed a cystic mass with a mural nodule, which seemed to originate from the tail of the pancreas. At laparotomy the cyst was not adhered to the pancreas but localized retroperitoneally. Histologic examination showed a mucinous cystadenoma with only foci of borderline malignancy with a mural "sarcoma-like" nodule. In view of the surgical and histopathological findings, the mucinous cystadenoma was regarded as primary retroperitoneal. This case demonstrates that in the era of radiological preoperative refinement, pathological diagnosis remains of utmost importance, especially for rare cases.
原发性腹膜后囊腺瘤极为罕见。本文献首次报道了一例伴有肉瘤样壁结节的原发性腹膜后囊腺瘤。一名45岁女性主诉左侧腹部肿块。计算机断层扫描显示一个有壁结节的囊性肿块,似乎起源于胰腺尾部。剖腹手术时,囊肿未与胰腺粘连,而是位于腹膜后。组织学检查显示为黏液性囊腺瘤,仅见交界性恶性灶及一个壁“肉瘤样”结节。鉴于手术及组织病理学检查结果,该黏液性囊腺瘤被视为原发性腹膜后肿瘤。该病例表明,在术前影像学精细化的时代,病理诊断仍然至关重要,尤其是对于罕见病例。