Thursday, December 8, 2011

Cystic Retroperitoneal Masses: Differential Diagnosis

  • Epithelial neoplasms: Mucinous cystadenoma or cystadenocarcinoma, serous cystadenocarcinoma, perianal mucinous cystadenocarcinoma (rare, associated with history of anal fistula).
  • Mesothelial neoplasms: Mesothelioma.
  • Germ cell neoplasms: Cystic teratoma.
  • Neuroendocrine neoplasms: Paraganglioma.
  • Neural neoplasm: Schwannoma.
  • Sarcoma: Necrotic areas can appear cystic.
  • Lymphovascular: Lymphangioma, lymphangiomatosis, lymphangioleiomyoma.
  • Developmental: Müllerian cyst, epidermoid cyst, tailgut cyst, bronchogenic cyst (subdiaphragmatic location).
  • Miscellaneous fluid collections: Hematoma, urinoma, abscess, lymphocele (shown above in a patient with testicular cancer, post lymph node dissection), pseudocyst (pancreatic, and nonpancreatic), pseudomyxoma retroperitonei (caused by a ruptured mucocele of the appendix).

References

Rajiah P, Sinha R, Cuevas C, Dubinsky TJ, Bush WH Jr, Kolokythas O. Imaging of uncommon retroperitoneal masses. Radiographics. 2011 Jul-Aug;31(4):949-76.

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