Primary retroperitoneal soft tissue sarcoma: Imaging appearances, pitfalls and diagnostic algorithm

Eur J Surg Oncol. 2017 Jul;43(7):1191-1198. doi: 10.1016/j.ejso.2016.10.032. Epub 2016 Dec 9.

Abstract

Although retroperitoneal sarcomas are rare tumours, they can be encountered by a wide variety of clinicians as they can be incidental findings on imaging or present with non specific symptoms and signs. Surgical resection can offer hope of cure and patient outcomes are improved when patients are managed in high-volume specialist centers. Failure to recognize retroperitoneal sarcomas on imaging can lead to inappropriate management in inexperienced centers. Therefore it is critical that a diagnosis of retroperitoneal sarcoma should be considered in the differential diagnosis of a retroperitoneal mass with prompt referral to a soft tissue sarcoma unit. In particular, the most common retroperitoneal sarcoma subtypes, liposarcoma and leiomyosarcoma, have characteristic imaging appearances which are discussed. This review therefore aims to set the context and guide clinicians through a diagnostic pathway for retroperitoneal masses in adults which arise extrinsic to the solid abdominal viscera.

Keywords: CT; Diagnosis; MRI; Retroperitoneum; Soft tissue sarcoma.

Publication types

  • Review

MeSH terms

  • Algorithms*
  • Biopsy, Large-Core Needle
  • Contrast Media
  • Diagnosis, Differential
  • Humans
  • Image-Guided Biopsy
  • Magnetic Resonance Imaging
  • Retroperitoneal Neoplasms / diagnostic imaging*
  • Retroperitoneal Neoplasms / pathology*
  • Retroperitoneal Neoplasms / therapy
  • Sarcoma / diagnostic imaging*
  • Sarcoma / pathology*
  • Sarcoma / therapy
  • Tomography, X-Ray Computed*

Substances

  • Contrast Media