Sunday, August 28, 2011

Retroperitoneal Mass with Calcification

Differential considerations for a retroperitoneal mass with calcification can be divided into benign and malignant conditions. Benign causes can be further divided into neoplastic and non-neoplastic.

  • Posttraumatic calcified hematoma:
  • Myositis ossificans: In the setting of trauma
  • Foreign body granuloma: In the setting of penetrating trauma (iatrogenic or otherwise). May have contrast enhancement if there is a significant inflammatory component.
Benign neoplastic
  • Tumors of neural origin: Ganglioneuroma, schwannoma, paraganglioma. Usually heterogeneous with T2-hyperintense areas and marked contrast enhancement.
  • Hemangioma: Phleboliths. T2-hyperintense.
  • Mature teratoma: Heterogeneous contents with with fluid and fat.
Malignant neoplastic
  • Undifferentiated pleomorphic sarcoma: Formerly known as malignant fibrous histiocytoma (MFH). Heterogeneous mass with myxoid stroma and/or collagen fibers
  • Dedifferentiated liposarcoma: Heterogeneous mass with or without bulky calcification in part of the tumor.
  • Malignant mesenchymoma: Heterogeneous mass. By definition has two or more malignant fibrosarcomatous components.
  • Malignant teratoma: Heterogeneous mass. Occurs in young patients.
  • Extraskeletal osteosarcoma: Variable amount of mineralization with typically intense and amorphous calcification. Nonmineralized areas iso-attenuating to muscle and intermediate signal on T1-weighted images. Variable contrast enhancement.


Secil M, Mungan U, Yorukoglu K, Dicle O. Case 89: Retroperitoneal extraskeletal osteosarcoma. Radiology. 2005 Dec;237(3):880-3.

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