Iwagami Sohei, Oura Shoji, Nishihata Masaya
Department of Urology Kishiwada Tokushukai Hospital Kishiwada Japan.
Department of Surgery Kishiwada Tokushukai Hospital Kishiwada Japan.
IJU Case Rep. 2025 May 9;8(4):315-318. doi: 10.1002/iju5.70025. eCollection 2025 Jul.
Leiomyosarcomas of ovarian veins often affect the IVC, the duodenum, and kidneys. Therefore, the resectability of the leiomyosarcomas highly depends on the presence or extent of their invasion to the surrounding organs.
A 55-year-old woman with a retroperitoneal mass on CT was referred to our hospital. CT and MRI showed a lobulated large mass with broad contact with the duodenum. EUS showed focal internal high echoes in the tumor areas adjacent to the duodenum. After obtaining the pathological diagnosis of leiomyosarcoma, the tumor was successfully removed without duodenum resection. Post-operative pathological findings confirmed the absence of direct leiomyosarcoma invasion to the duodenum and the sparse atypical cells with edematous background in the high internal echo areas.
Surgeons should note that internal high echoes in the tumor areas adjacent to the duodenum can be an important predictor of possible resection of the retroperitoneal tumors.
卵巢静脉平滑肌肉瘤常累及下腔静脉、十二指肠和肾脏。因此,平滑肌肉瘤的可切除性很大程度上取决于其对周围器官的侵犯情况及范围。
一名55岁女性,CT检查发现腹膜后肿块,转诊至我院。CT和MRI显示一个分叶状大肿块,与十二指肠广泛接触。超声内镜显示在与十二指肠相邻的肿瘤区域有局灶性内部高回声。在获得平滑肌肉瘤的病理诊断后,肿瘤成功切除,未行十二指肠切除术。术后病理结果证实平滑肌肉瘤未直接侵犯十二指肠,且高内部回声区域有稀疏的非典型细胞及水肿背景。
外科医生应注意,与十二指肠相邻的肿瘤区域出现内部高回声可能是腹膜后肿瘤可切除的重要预测指标。