Improta Luca, Tzanis Dimitri, Bouhadiba Toufik, Abdelhafidh Khoubeyb, Bonvalot Sylvie
Department of General Surgery, Università Campus Bio-Medico, 200 Via Alvaro del Portillo, Rome, Italy.
Department of Surgery, Institut Curie, PSL University, 26 Rue d'Ulm, Paris, France.
Eur J Surg Oncol. 2020 Sep;46(9):1573-1579. doi: 10.1016/j.ejso.2020.04.054. Epub 2020 May 21.
In front of a primary retroperitoneal tumour, it is necessary to have in mind all possible diagnoses in order to specify the diagnostic strategy and the treatment. According to the World Health Organization (WHO) classification of tumours, mesenchymal benign and malignant tumours (including sarcomas and, currently, neurogenic tumours), parasympathetic tumours, extragonadal germ cell tumours, and lymphoid tumours have been identified. By definition, primary retroperitoneal tumours start independently from the retroperitoneal organs. Secondary lesions, carcinoma metastasis, and adenopathy are excluded from this definition, but they can also develop in the retroperitoneal space and lead to misdiagnoses. In the absence of positive tumour markers or an evocative biology, percutaneous biopsy is necessary. Pathological diagnosis is necessary to decide whether surgery must be done, its timing among the other treatments, and its extension. This paper summarizes all the diagnostic possibilities.
对于原发性腹膜后肿瘤,必须考虑到所有可能的诊断,以便明确诊断策略和治疗方案。根据世界卫生组织(WHO)的肿瘤分类,已确定间叶组织良性和恶性肿瘤(包括肉瘤以及目前的神经源性肿瘤)、副交感神经肿瘤、性腺外生殖细胞肿瘤和淋巴瘤。根据定义,原发性腹膜后肿瘤独立于腹膜后器官发生。继发性病变、癌转移和腺病不在此定义范围内,但它们也可在腹膜后间隙发生并导致误诊。在没有阳性肿瘤标志物或提示性生物学特征的情况下,经皮活检是必要的。病理诊断对于决定是否必须进行手术、手术在其他治疗中的时机以及手术范围至关重要。本文总结了所有的诊断可能性。