Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucía, Cartagena, Spain.
Servicio de Anatomía Patológica, Hospital General Universitario Santa Lucía, Cartagena, Spain.
Pan Afr Med J. 2020 Oct 27;37:186. doi: 10.11604/pamj.2020.37.186.26344. eCollection 2020.
Differential diagnosis of retroperitoneal masses may become complex and requires careful anamnesis, physical examination and several complementary tests. We present the clinical case of a male patient aged 45 years who was diagnosed with a 4cm paraaortic lesion compatible with neuroendocrine tumor in the abdominal computed tomography (CT) exam. The workup performed with SPECT-CT, somatostatin receptors scintigraphy, MIBG scintigraphy, 24-hour urine total and fractionated catecholamines and 24-hour urine 5-OH indoleacetic did not confirm the first diagnostic impression. Finally, the lesion was biopsied and presence of micro-organisms was revealed. Further exams confirmed schistosomiasis as the cause of the paraaortic lesion. Histological diagnosis can be helpful with regard to the differential diagnosis of retroperitoneal masses.
腹膜后肿块的鉴别诊断可能变得复杂,需要仔细的病史询问、体格检查和几项补充检查。我们呈现了一位 45 岁男性患者的临床病例,其在腹部计算机断层扫描(CT)检查中被诊断为 4cm 主动脉旁病变,符合神经内分泌肿瘤。通过 SPECT-CT、生长抑素受体闪烁显像、MIBG 闪烁显像、24 小时尿总儿茶酚胺和分馏儿茶酚胺、24 小时尿 5-羟吲哚乙酸进行的检查未证实最初的诊断印象。最后,对病变进行了活检,发现了微生物。进一步的检查证实了该患者患有血吸虫病,这是导致主动脉旁病变的原因。组织学诊断对于腹膜后肿块的鉴别诊断可能有帮助。