Laparoscopic Resection and Pre-Operative Imaging of Primary Retroperitoneal Mucinous Neoplasms: A Retrospective Case Series
Received 16 March 2020
Accepted for publication 11 June 2020
Published 6 July 2020 Volume 2020:12 Pages 5451—5460
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Seema Singh
Yuyang Zhang,1 Jiejin Yang,2 Zeyang Chen,1 Jiali Sun,2 Pengyuan Wang1
1Department of General Surgery, Peking University First Hospital, Peking University, Beijing, People’s Republic of China; 2Department of Radiology, Peking University First Hospital, Peking University, Beijing, People’s Republic of China
Correspondence: Pengyuan Wang
Department of General Surgery, Peking University First Hospital, Peking University, Beijing 100034, People’s Republic of China
Purpose: The purpose of this paper is to present the clinicopathological features of primary retroperitoneal mucinous neoplasms (PRMNs), to evaluate the diagnostic role of pre-operative radiological examinations, and to determine the feasibility of total resection using the laparoscopic approach.
Methods: We retrospectively analysed the clinicopathological and radiological features of 10 PRMN cases who underwent surgical resection from January 2000 to December 2019.
Results: Ten PRMN cases were evaluated in this study, including 1 malignant case, 4 borderline cases, and 5 benign cases. The most common primary complaints were pain (60%) and palpable mass (60%). Of the 8 cases with pre-operative CT results, 75% of the borderline or malignant cysts and none of the benign cysts were large in size (size> 11.6 cm). Half of the non-benign masses and none of the benign ones were lobulated. Thick wall (≥ 3 mm) and irregular wall were found in 25% and 50% of the non-benign cases, respectively. Wall enhancement was detected in 75% of the non-benign cases and 25% of the benign cases. Enhanced mural nodules were identified in 50% of the non-benign patients. Septa were found in 25% of the non-benign cases. Complete dissection of the tumour without rupture or post-operative complications was achieved laparoscopically in 90% of the cases. All patients were alive with no recurrence at the last follow-up at an average of 28.1± 26.6 months.
Conclusion: Larger size and lobulation of the cyst, presence and contrast enhancement of thick and irregular cyst walls, mural nodules, and internal septa may be imaging features suggestive of malignancy. Complete resection of PRMN through the laparoscopic approach is feasible in experienced institutions.
Keywords: primary retroperitoneal mucinous tumour, laparoscopy, radiological features, CT
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