A Case of Cyst Formation (Venous Origin) of Retroperitoneum, which pressed Duodenum and Inferior Vena Cava

Naoki Haruta, Kazurou Okada and Yuzou Hayashi*

Department of Surgery, and Department of Pathology*, Takanobashi Central Hospital, Jinyoukai Medical Corporation, Hiroshima, Japan

A case of retroperitoneal venous aneurysm, which was found during screening examinations for swelling of the legs, is reported. A 78-year-old man was detected to have a cystic tumor in the retroperitoneum by computed tomography in September 2004. This tumor had increased in size during follow-up over twenty one months, therefore, the patient was admitted for operation. Computed tomography and magnetic resonance imaging revealed a cystic mass, 6 cm in diameter, pressing the duodenum upward and inferior vena cava to the left and backward. Transperitoneal extirpation of the cystic tumor was conducted on June 26, 2006. The extirpated specimen was almost spherical and was encapsulated by a thin elastic wall, measured 6.4 cm in maximum diameter and weighed 94 g, and contained yellowish serous fluid. Microscopically, the cyst wall and contents showed no evidence of malignancy. The results of Masson's trichrome staining and Elastica von Gieson stainingsuggested that the tumor originated from a blood vessel. Immunohistochemically, the inner cells of the tumor were positive for CD31 and factor VIII, partially positive for CD34, and negative for D2-40. Based on these findings, the tumor was diagnosed to be a retroperitoneal venous aneurysm, which is a very rare condition. The patient remains well without recurrence at present, 14 months after the operation.

Key words
venous aneurysm, venous dilatation, retroperitoneal tumor

Reprint requests
Naoki Haruta Department of Surgery, Takanobashi Central Hospital, Jinyoukai Medical Corporation
2-4-16 Kokutaijicho, Naka-ku, Hiroshima, 730-0042 JAPAN

Accepted
September 26, 2007

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