URINARY Section 2: Renal mass: Retroperiteoneal neoplasmes Flashcards
Seen in big fat people - with the classic history of “incomplete bladder emptying”
Lipomatosis
Overgrowth of benign fat in the pelvis classically perirectal and perivesicular spaces.
Retroperitoneal lipomatosis
Overgrowth of benign fat in the pelvis classically perirectal and perivesicular spaces.
Lipomatosis
“Pear-shaped”
“Interted tear drop”
Retroperitoneal liposarcoma
Fat-containing retroperitoneal lesions should be thought of like a male resident on the mammography service- guilty of all crimes until proven innocent.
If you see something you think is a giant fucking AML - but you aren’t totally sure it is coming from the kidney AND it has calcifications - you should think Liposarcoma.
Most common soft tissue sarcoma in children.
Rhabdo- Myosarcoma
You see a soft tissue mass (in a kid) - you should always be thinking about this.
Rhabdo- Myosarcoma
Half of Rhabdo- Myosarcoma will be in this location
and 1/4 will be in?
Neck.
1/4 = pelvis, bladder or testicles
Heterogenous, enhancing, possibly destroying nearby bone.
Rhabdo- Myosarcoma
Abnormal deposits of hematopoietic tissue outside the bone marrow.
Extra - Medullary Hematopoiesis
The look is super non- specific -just a bunch of soft tissue masses in the para- vertebral region.
Extra - Medullary Hematopoiesis
Classic history of hemoglobinopathy, myelofibrosis, leukemia - etc…
Extra - Medullary Hematopoiesis
The Most Common retroperitoneal malignancy.
Lymphoma
Tons of Big Nodes or a Confluent Soft Tissue Mass.
Lymphoma
nodes that are more likely to be larger, non- continuous, and involve the mesentery.
Non-Hodgkin Lymphoma
odes are more likely to involve the para- aortic region early, and be more continuous
Hodgkin lymphoma
is excellent for Lymphoma (in particular it is very useful for disease vs treated residual scarring
PET/CT
Most common cause of retroperitoneal hemorrhage?
Over-Anticoagulation (High PT/INR)
2nd most common cause of RP hemorrhage
Ruptured/leaking aorta.
3rd most common cause of RP hemorrhage?
Bleedong RCC or AML
“Mantle Like Soft Tissue Mass Around the Aorta , IVC, and/or Ureters”
- This has a classic DDx of:
Lymphoma = displaces tha aorta forward
RP Fibrosis = no displacement
Erdheim Chester = + bilataeral symmetric sclerosis
