A CARE-compliant article: A case report of retroperitoneal endometrial stromal sarcoma with multiple pulmonary metastases and literature review.

RATIONALE: Endometrial stromal sarcoma is an extremely rare mesenchymal neoplasm occurring in the extrauterine. Retroperitoneal endometrial stromal sarcoma with multiple pulmonary metastases, in particular, is extremely rare. PATIENT CONCERNS: Forty-seven-year-old woman (gravida 3, para 2), was referred to our institution with complaints of fever. DIAGNOSES: Ultrasound and computed tomographic imaging of the abdomen identified the presence of masses in the pelvic region. Additionally, computed tomographic scans and X-ray evaluations of the thorax detected dispersed masses in both the lungs and pelvic area. Histopathological analysis of the pelvic region indicated the presence of low-grade endometrial stromal sarcoma. A computed tomography-guided pneumocentesis was conducted to further characterize the pulmonary lesions, confirming the diagnosis of low-grade endometrial stromal sarcoma. INTERVENTIONS: The patient underwent tumor resection, subsequent treatment with Medroxyprogesterone acetate for 6 months, received microwave ablation for multiple lung metastases, PARP1 inhibitor for 4 courses, and has been undergoing chemotherapy (epirubicin/ifosfamide) up to the present time. OUTCOMES: Partial remission was obtained after the above treatment and this patient is now still alive maintaining for 3 years. LESSONS: The identification and management of this disease remain a significant challenge due to its low prevalence. Further research involving a larger number of cases is necessary to ensure consistency in diagnosis and to establish effective treatment guidelines.

Diagnosis and treatment of malignant retroperitoneal mesothelioma: A case report.

RATIONALE: Malignant peritoneal mesothelioma (MPM) is a rare clinical disease. Although there are several reports describing intraperitoneal mesothelioma of the lung, liver, and intestine, retroperitoneal mesothelioma is, to our knowledge, very rare and rarely reported. In recent years, our best clinical protocols for the treatment and diagnosis of retroperitoneal mesothelioma have not been proven and the diagnosis and treatment are challenging. PATIENT CONCERNS: A 37-year-old Chinese woman complained of bilateral low back pain for a month, with obvious symptoms of low back pain on the left side. To treat low back pain, retroperitoneal masses were found during physical examination. The patient consulted a urological specialist for further treatment. DIAGNOSIS: After the operation, pathological biopsy confirmed retroperitoneal epithelioid diffuse mesothelioma. INTERVENTIONS: After exclusion of surgical contraindications, the patient underwent laparoscopic retroperitoneal lesion resection under tracheal intubation and general anesthesia, and the operation was successful. OUTCOMES: On the tenth day after surgery, the patient vital signs were stable, and he was discharged. LESSONS: Patients with malignant peritoneal mesothelioma may have no typical clinical symptoms, and the diagnosis is based on pathological and immunohistochemical examination. In selected patients, surgical cell reduction and intraoperative intraperitoneal heat chemotherapy have become the first choice of treatment, which can achieve ideal therapeutic effects and prolong survival.

Metastasis-directed therapy in testicular cancer.

PURPOSE OF REVIEW: This review highlights the importance of addressing testicular cancer metastasizing beyond the retroperitoneum, focusing on multidisciplinary approaches and advances in treatment. RECENT FINDINGS: Recent literature emphasizes on the evolving landscape of metastasis-directed therapy, including surgical interventions, chemotherapy regimens, and radiation therapy. The effectiveness of these treatments varies depending on the site of metastasis, with various approaches improving survival rates and quality of life for patients. We divide our review in an organ-specific manner and focus on chemotherapeutic, surgical, and radiation therapy approaches pertaining to each site of metastasis. SUMMARY: Our review suggests the pressing need for continued research to refine and personalize treatment strategies. These efforts are important for enhancing clinical practice, ultimately leading to better outcomes for patients with metastatic testicular cancer.

Advancements in Diagnosis and Multimodal Treatment Strategies for Retroperitoneal Tumors: A Comprehensive Review.

Retroperitoneal tumors (RPTs) encompass both benign and malignant entities, constituting ~0.1% to 0.2% of all malignant tumors, of which 70% to 80% manifest malignancy. Predominantly, retroperitoneal sarcomas (RPS) represent the most prevalent subtype among RPT. With over 70 histologic forms identified, liposarcomas and leiomyosarcomas emerge as the primary constituents of RPS. Accurate diagnosis of RPTs necessitates preoperative core-needle biopsy and comprehensive imaging assessment. The current staging protocol for RPS relies on the eighth edition of the American Joint Committee on Cancer/TNM classification. Surgical excision remains the established gold standard for treating RPS. Therapeutic approaches vary according to the underlying pathophysiology. Although chemotherapy and radiotherapy exhibit efficacy in managing metastatic and recurrent unresectable RPS, their role in primary RPS remains unresolved, necessitating further clinical trials for validation. Concurrently, ongoing research explores the potential of targeted therapies and immunotherapy. This literature review aims to provide a comprehensive overview of existing research, delineating diagnostic pathways and optimal therapeutic strategies for RPT.

Retroperitoneal sarcoma: a 10-year follow-up analysis using hospital-based cancer registry data in Japan.

OBJECTIVES: We sought clinical characteristics, survival outcomes, and prognostic factors for overall survival of retroperitoneal sarcoma in Japan. METHODS: A Japanese hospital-based cancer registry database with a pivotal 10-year follow-up was used to identify and enroll patients, registered from 106 institutions, diagnosed with retroperitoneal sarcoma in 2008-2009. Treating hospitals were divided by hospital care volume; high-volume hospitals and low-volume hospitals were defined as ≥ 4 and < 4 cases/year, respectively. RESULTS: A total of 91 men and 97 women were included, with a median age of 64 years. The most common histological type was liposarcoma in 101 patients, followed by leiomyosarcoma in 38 patients. The 5-year and 10-year overall survival rates were 44.1 and 28.3%. The majority of patients (n = 152, 80.9%) were treated at low-volume hospitals. High-volume hospital patients had higher 10-year overall survival rates than low-volume hospital patients (51.2% vs 23.2%, P = 0.026). Multivariate analysis revealed age over 60 years, treatment in low-volume hospitals and chemotherapy were independent predictors of unfavorable survival while treatment with surgery was an independent predictor of favorable survival. CONCLUSIONS: The possibility of surgical removal was suggested to be the most important prognostic factor for retroperitoneal sarcoma. Better survival was shown in patients treated at high-volume hospitals in our series.

Treatment of retroperitoneal sarcoma results in improved outcomes.

OBJECTIVE: To report the clinical characteristics, treatments, and outcomes in a cohort of dogs with histologically confirmed retroperitoneal sarcoma (RPS) and to identify potential variables of prognostic significance. ANIMALS: 46 client-owned dogs from 10 clinics with histopathologic diagnosis of a sarcoma originating from the retroperitoneal space. METHODS: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed to report descriptive data for all cases and overall survival time. Multivariate analysis was utilized to evaluate prognostic factors for overall survival. RESULTS: Hemangiosarcoma was the most common histologic subtype diagnosed (76.1%). Cytoreductive and curative intent surgical excision of the RPS was attempted in 12 and 22 dogs, respectively; 12 dogs underwent no surgery or had an exploratory laparotomy with incisional biopsy only. Nineteen dogs received adjuvant chemotherapy, either injectable or metronomic, and 1 dog received adjuvant radiation therapy. Fourteen of the 34 (41.2%) surgically treated dogs developed evidence of local recurrence, but there was no difference in local recurrence when comparing dogs categorized as curative intent versus cytoreductive surgery. The median overall survival time was 238 days. On multivariable analysis, treatment approach was associated with survival with surgical excision (vs palliative treatment) and adjuvant chemotherapy following surgery being protective against death. A diagnosis of hemangiosarcoma was associated with a greater hazard of death. CLINICAL RELEVANCE: This study demonstrates a substantially greater survival time than previously published and suggests a survival benefit from surgical excision and adjuvant chemotherapy.

Tumor desmoplásico de célula pequeña y redonda paratesticular/testicular: reporte de caso y revisión de la literatura / Paratesticular/testicular desmoplastic round small cell malignant tumor: case report and literature review

Resumen El tumor desmoplásico de célula redonda y pequeña (TDCRP) es una patología neoplásica maligna agresiva y poco común. Afecta predominantemente a hombres entre la segunda y tercera década de la vida. Los pacientes que la padecen tienen un pronóstico pobre, con una supervivencia global a 5 años de hasta el 30%. Por lo general se presenta como una masa en la cavidad abdominal, frecuentemente multifocal. Para su tratamiento se recomienda un enfoque multimodal con cirugía, quimioterapia y radioterapia. Poco más de 20 casos de TDCRP a nivel testicular/paratesticular se han reportado en la literatura. A continuación, se presenta un caso ilustrativo en esta localización, se discute el caso y se realiza revisión de la literatura.

Abstract Desmoplastic small round cell tumor (DSRCT) is an aggressive and rare malignant neoplasm. It mainly affects young men in their twenties and thirties. Patients with it have a poor prognosis, with a 5-year survival rate of up to 30%. It generally presents as a mass in the abdominal cavity, often multifocal. A multimodal approach is recommended for its treatment, with surgery, chemotherapy, and radiotherapy. Just over 20 cases of testicular/paratesticular DSRCT have been reported in the literature. Below, we present an illustrative case in this location, we discuss the case and review the literature.

Actualización en el manejo de sarcomas retroperitoneales y pélvicos; el papel de la cirugía compartimental / Update in pelvic and retroperitoneal sarcoma management: The role of compartment surgery

La cirugía de los sarcomas retroperitoneales debe ser compartimental «en bloque», lo que implica la resección de órganos adyacentes al tumor. Su empleo «de entrada» permite un elevado porcentaje de resecciones con márgenes negativos, lo que supone un mejor control local y mayor supervivencia en muchos pacientes. La preservación de órganos debe hacerse de forma personalizada, especialmente en la pelvis, y adaptarla a la agresividad histológica del tumor. La biopsia preoperatoria permite establecer el subtipo de sarcoma y una adecuada estrategia perioperatoria. Estos pacientes deben ser manejados por cirujanos expertos en centros de referencia, con unidades multidisciplinarias y comités oncológicos. El uso de quimioterapia y radioterapia aún no está bien definido, por lo que solo se recomienda en centros de referencia con ensayos clínicos. En la actualidad esta es la única opción para ofrecer las mejores tasas de morbimortalidad, y las posibles mejoras en la supervivencia de estos pacientes

Surgery for retroperitoneal sarcomas should be "en bloc" compartmental, which involves resection of unaffected organs. Its upfront use is key, providing a high percentage of resections with negative margins, resulting in a better local control and increased survival in many patients. Preservation of organs should be done in an individualized manner, especially in the pelvic location, and adapted to the histological aggressiveness of the tumor. Preoperative biopsy is able to establish the diagnosis of sarcoma subtype and consequently an adequate perioperative strategy. These patients should be managed by expert surgeons at referral centers with multidisciplinary units and oncology committees. The use of chemotherapy and radiotherapy is not yet well defined, so it is only recommended at referral centers with clinical trials. Currently, this is the only option to offer the best morbidity and mortality rates, as well as possible improvements in the survival of these patients

SEOM Clinical Guideline of management of soft-tissue sarcoma (2016)

Soft-tissue sarcomas are uncommon and heterogeneous tumors of mesenchymal origin. A soft-tissue mass that is increasing in size, greater than 5 cm, or located under deep fascia are criteria for suspicion of sarcoma. Diagnosis, treatment, and management should preferably be performed by a multidisciplinary team in reference centers. MRI and lung CT scan are mandatory for local and distant assessment. A biopsy indicating histological type and grade is needed previous to the treatment. Wide surgical resection with tumor-free tissue margin is the primary treatment for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not likely of being improved with reexcision. Neoadjuvant and adjuvant chemotherapy improve survival in selected cases, usually in high-grade sarcomas of the extremities. In the case of metastatic disease, patients with exclusive lung metastasis could be considered for surgery. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. New drugs have shown activity in second-line therapy and in specific histological subtypes (AU)

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Schwannoma ancient retroperitoneal: Reporte de un caso / Retroperitoneal ancient schwannoma: case report

Los neurinomas (neurilemmomas o schwannomas) son tumores de los nervios periféricos derivados de la proliferación neoplásica de las células de Schwann. Aunque su localización preferente es en cabeza y cuello, hasta un 3% son retroperitoneales, encontrándose en su mayor parte asociados a la enfermedad de Von Recklinghausen. En general, los neurinomas son tumores benignos, con lento crecimiento que provocan manifestaciones clínicas escasas e inespecíficas. La incidencia de neoplasias retroperitoneales primitivas varía del 0,3 al 3%. Los sarcomas suponen el grupo más frecuente de neoplasias retroperitoneales, siendo el Schwannoma un tumor inusual con una incidencia del 1% al 5% de los tumores retroperitoneales primarios. El schwannoma también denominado neurinoma o neurilemoma, es un tumor derivado de las células de Schwann de los nervios periféricos. Se caracteriza por su inespecificidad clínica y radiológica, siendo el diagnóstico anatomopatológico, con intensa positividad inmunohistoquímica a la proteína S-100. El tratamiento de elección es la exéresis quirúrgica, con márgenes amplios; no estando descritos casos de malignización ni de metástasis a distancia, pero si la existencia de recurrencia a nivel local probablemente secundaria a resección incompleta...

Schwannoma ancient retroperitoneal: Reporte de un caso / Retroperitoneal ancient schwannoma: case report

Los neurinomas (neurilemmomas o schwannomas) son tumores de los nervios periféricos derivados de la proliferación neoplásica de las células de Schwann. Aunque su localización preferente es en cabeza y cuello, hasta un 3% son retroperitoneales, encontrándose en su mayor parte asociados a la enfermedad de Von Recklinghausen. En general, los neurinomas son tumores benignos, con lento crecimiento que provocan manifestaciones clínicas escasas e inespecíficas. La incidencia de neoplasias retroperitoneales primitivas varía del 0,3 al 3%. Los sarcomas suponen el grupo más frecuente de neoplasias retroperitoneales, siendo el Schwannoma un tumor inusual con una incidencia del 1% al 5% de los tumores retroperitoneales primarios. El schwannoma también denominado neurinoma o neurilemoma, es un tumor derivado de las células de Schwann de los nervios periféricos. Se caracteriza por su inespecificidad clínica y radiológica, siendo el diagnóstico anatomopatológico, con intensa positividad inmunohistoquímica a la proteína S-100. El tratamiento de elección es la exéresis quirúrgica, con márgenes amplios; no estando descritos casos de malignización ni de metástasis a distancia, pero si la existencia de recurrencia a nivel local probablemente secundaria a resección incompleta...(AU)

Lipossarcoma gigante de retroperitônio / Giant Retroperitoneal Liposarcoma / Liposarcoma Retroperitoneal Gigante

Introdução: Neoplasias mesenquimais, apesar de infrequentes, podem se apresentar como um desafio terapêutico quando atingem grandes proporções. O objetivo dos autores é descrever o caso de um lipossarcoma retroperitoneal que, devido a seu grande volume, apresentou peculiaridades em seu planejamento terapêutico, bem como revisar sua apresentação clínica, diagnóstico e tratamento. Relato do caso: Homem, 52 anos, consultou com queixa de aumento da circunferência e volumosa massa abdominal palpável. Tomografia computadorizada e ressonância magnética do abdômen revelaramgrande lesão expansiva no retroperitônio, com deslocamento de diversas vísceras intra-abdominais, sugestiva de volumoso tumor maligno de origem retroperitoneal. O paciente foi submetido à laparotomia com ressecção da massa em conjunto com o rim direito. O exame anatomopatológico revelou tratar-se de lipossarcoma desdiferenciado medindo 62 cm nomaior diâmetro, com peso de 19 kg. Foi indicado tratamento complementar com radioterapia. Houve excelente evoluçãopós-operatória, estando o paciente assintomático 36 meses após o procedimento. Conclusão: Os lipossarcomas do retroperitônio são uma entidade clínica rara, com apresentação clínica variável conforme sua localização, tipo histológico, grau de malignidade e tamanho. A única possibilidade de cura ainda é a ressecção cirúrgica radical com margens livres. Desde que o paciente apresente boas condições clínicas de tolerar o procedimento, o tamanho volumoso do tumor não é necessariamente uma contraindicação ao tratamento cirúrgico.

Liposarcoma retroperitoneal recidivante / Recidivant retroperitoneal liposarcoma

Los liposarcomas retroperitoneales son tumores infrecuentes. Sus peculiaridades biológicas y clínicas les confieren algunos aspectos diferenciales respecto al resto de los sarcomas retroperitoneales. Se presenta el caso de una paciente de 59 años con el diagnóstico de liposarcoma retroperitoneal, variedad mixoide, con recidiva en cuatro oportunidades, realizándose en todas exéresis completa del tumor, sin extirpación de órganos vecinos, con radioterapia como tratamiento adyuvante. La supervivencia de esta paciente fue de cuatro años. La elevada tendencia a la recidiva de estos tumores determina un pronóstico global malo.

Retroperitoneal liposarcomas are infrequent tumors. Their biological and clinical peculiarities confer them some differential aspects regarding the rest of retroperitoneal sarcomas. The case of a 59 year-old patient is presented with the diagnosis of retroperitoneal liposarcoma, myxoid variety, with recidivation in four opportunities, being carried out in all complete exeresis of the tumor, without extirpation of neighbor organs, with radiotherapy as adjuvant treatment. This patient's survival was of four years. The high tendency to recidivation of these tumors determines a bad global prognosis.

Liposarcoma retroperitoneal recidivante / Recidivant retroperitoneal liposarcoma

Los liposarcomas retroperitoneales son tumores infrecuentes. Sus peculiaridades biológicas y clínicas les confieren algunos aspectos diferenciales respecto al resto de los sarcomas retroperitoneales. Se presenta el caso de una paciente de 59 años con el diagnóstico de liposarcoma retroperitoneal, variedad mixoide, con recidiva en cuatro oportunidades, realizándose en todas exéresis completa del tumor, sin extirpación de órganos vecinos, con radioterapia como tratamiento adyuvante. La supervivencia de esta paciente fue de cuatro años. La elevada tendencia a la recidiva de estos tumores determina un pronóstico global malo(AU)

Retroperitoneal liposarcomas are infrequent tumors. Their biological and clinical peculiarities confer them some differential aspects regarding the rest of retroperitoneal sarcomas. The case of a 59 year-old patient is presented with the diagnosis of retroperitoneal liposarcoma, myxoid variety, with recidivation in four opportunities, being carried out in all complete exeresis of the tumor, without extirpation of neighbor organs, with radiotherapy as adjuvant treatment. This patient's survival was of four years. The high tendency to recidivation of these tumors determines a bad global prognosis(AU)

Abordaje laparoscópica de un tumor retroperitoneal: reporte de un caso y revisión de la literatura / Laparoscopic management of a retroperitoneal tumor. Case report and literature review

OBJETIVOS: Los tumores retroperitoneales son infrecuentes y usualmente la mayoría son malignos. Presentamos el abordaje y resolución por vía laparoscópica de un leiomiosarcoma retroperitoneal de bajo grado.MÉTODOS: Se presenta una paciente de 56 años de edad con diagnóstico de una masa retrorenal de 12 cm en su diámetro mayor que fue intervenida laparoscopicamente por vía transperitoneal. Durante la cirugía el tumor fue claramente visualizado sobre el aspecto latero-posterior del riñón izquierdo. Utilizando una técnica oncologicamente segura, el tumor fue cuidadosamente liberado de la cápsula renal y extraído en una bolsa plástica por una pequeña incisión en la fosa ilíaca izquierda. RESULTADOS: El tiempo operatorio fue de 135 minutos y el sangrado estimado en 200 ml. La paciente evolucionó favorablemente y fue externada al tercer día postoperatorio. El análisis final de la pieza operatoria develó un leiomiosarcoma de muy bajo grado de malignidad. Luego de 6 meses de seguimiento, la paciente se encuentra libre de enfermedad y completamente recuperada.CONCLUSIONES: Aunque la cirugía abierta continua siendo el estándar en el tratamiento de todos los tumores retroperitoneales, el abordaje laparoscópico de una masa retroperitoneal es técnicamente factible y oncologicamente seguro. Se necesitan mayores estudios para probar su efectividad a largo plazo(AU)

OBJECTIVES: Retroperitoneal tumors are a rare finding and most masses are of malignant origin. We report laparoscopic management of a low grade retroperitoneal leiomyosarcoma.METHODS: A 56 year old woman with a left 12 cm retro-renal mass underwent transperitoneal laparoscopic exploration. The tumor was clearly visualized on the lateral aspect of the left kidney. Following basic oncologic principles, the mass was carefully dissected off the renal capsule and extracted in a laparoscopic bag through a small incision on the left lower quadrant.RESULTS: Operative time was 135 minutes and estimated surgical bleeding was 200 ml. The patient evolved uneventfully and was discharged home on postoperative day 3. Final pathological analysis revealed that the lesion was a very low grade leiomyosarcoma. At six months follow-up the patient remains disease free and has completely recovered.CONCLUSIONS: Even though open surgery remains the standard treatment for all retroperitoneal tumors, the laparoscopic approach of a retroperitoneal mass is technically feasible and oncologically safe. Further studies will show long term results(AU)

Intensificación terapéutica intraoperatoria en el tratamiento de los sarcomas abdominales localmente avanzados / Intraoperative therapeutic intensification techniques in locally advanced abdominal sarcomas

Introducción. Los sarcomas son tumores infrecuentes que se desarrollan a partir de células mesenquimales. Su estudio y tratamiento es difícil debido a una histopatología, localización y comportamiento variables. En este artículo estudiamos el papel de las técnicas de intensificación terapéutica intraoperatoria: radioterapia intraoperatoria (RIO) y quimioterapia intraperitoneal intraoperatoria hipertérmica (QIOH), en el tratamiento de los sarcomas abdominales localmente avanzados y la sarcomatosis peritoneal. Material y métodos. Analizamos una serie de 20 pacientes consecutivos diagnosticados de sarcoma abdominal avanzado y 5 diagnosticados de sarcomatosis peritoneal, evaluados y tratados en nuestro servicio entre diciembre de 1996 y octubre de 2005. En el sarcoma localmente avanzado se realizó resección completa o máxima asociada a RIO. En sarcomatosis peritoneal se llevó a cabo la máxima citorreducción asociada a QIOH. Resultados. La tasa de supervivencia de los sarcomas abdominales avanzados sin sarcomatosis fue del 65% a los 26 meses. De los 5 pacientes con sarcomatosis peritoneal, 3 estaban vivos y 2 de ellos libres de enfermedad a los 20 meses de seguimiento. Conclusiones. La RIO asociada a cirugía radical parece mejorar el control local y la supervivencia en sarcomas abdominales avanzados. La citorreducción máxima más QIOH usada como tratamiento de la sarcomatosis peritoneal es una técnica factible y que ofrece una opción terapéutica con intención curativa (AU)

Introduction. Sarcomas are rare tumors that develop from mesenchymal cells. Their management is difficult due to their changing histology, location, and behavior. In this article, we discuss the use of two intraoperative therapeutic intensification techniques, intraoperative radiotherapy (IORT) and hyperthermic intraoperative intraperitoneal chemotherapy (HIIC), in the treatment of locally advanced abdominal sarcomas and peritoneal sarcomatosis. Material and methods. We analyzed a series of 20 consecutive patients diagnosed with advanced abdominal sarcoma and 5 patients with a diagnosis of peritoneal sarcomatosis who were evaluated and treated in our department from December 1996 to October 2005. In advanced abdominal sarcoma, we performed complete or maximal resection followed by IORT. In peritoneal sarcomatosis we performed massive cytoreduction followed by HIIC. Results. The survival rate in advanced abdominal sarcomas without sarcomatosis was 65% at 26 months. Among the 5 patients diagnosed with peritoneal sarcomatosis, 3 were alive, and 2 were without recurrence at 20 months of follow-up. Conclusions. IORT associated with radical surgery seems to improve local control and survival in advanced abdominal sarcomas. Maximal cytoreduction plus HIIC used as treatment of peritoneal sarcomatosis is a feasible technique that offers a therapeutic option with curative intent (AU)

Hematoma retroperitoneal con neuropatía del femoral, ¿actitud conservadora o quirúrgica? / Retroperitoneal hematoma with femoral neuropathy, conservative or surgical posture?

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Mielolipoma retroperitoneal / Retroperitoneal myelolipomas

El retroperitoneo es el espacio que se encuentra delimitado: por detrás, por la columna lumbar y los músculos psoas ilíaco y el cuadrado lumbar; por delante, por el peritoneo parietal posterior; por arriba, el diafragma; por debajo, el piso pelviano. Los tumores retroperitoneales representan el 1,8 por ciento del total de los tumores abdominales en nuestro servicio. Los mielolipomas comprenden el 0,08-0,4 por ciento de los mismos, siendo ellos tumores benignos compuestos por tejido adiposo y hematopoyético (incluye colonias eritroides, mieloides y megacariocíticas. El objetivo de este trabajo es definir alternativas terapéuticas en tumor benigno retroperitoneal

Paraganglioma extraadrenal retroperitoneal. Presentación de dos nuevos casos / Retroperitoneal extraadrenal paraganglioma. Report of two new cases

Presentamos 2 casos de paraganglioma retroperitoneal extraadrenal no diagnosticados preoperatoriamente, ya que simularon una tumoración hepática y pancreática, respectivamente. La ausencia de preparación preoperatoria adecuada y de diagnóstico originó en uno de nuestros pacientes importante labilidad tensional durante las maniobras de extirpación, que fue controlada de manera adecuada. Analizamos los principales aspectos clínicos, diagnósticos, terapéuticos y pronósticos de estos tumores poco frecuentes y realizamos una revisión de la bibliografía (AU)