A Case of Retroperitoneal Leiomyoma Showing a Cystic Lesion

Koichi Kato, Shin Takeda, Shuji Nomoto, Naohito Kanazumi, Hiroyuki Sugimoto and Akimasa Nakao

Department of Surgery II, Nagoya University Graduate School of Medicine

We report a case of retroperitoneal leiomyoma showing cystic lesion. A 47-year-old woman with a history of abdominal pain and discomfort was found in abdominal computed tomography (CT) to have a 10 cm diameter cystic mass with irregular walls in the right anterior pararenal space. The contents of the cystic lesion showed slightly high intensity on T1 weighted images, and extremely high intensity on T2W abdominal MRI. Endoscopic ultrasonography with a contrast agent showed prominent blood flow within the thickened cyst wall. Laparotomy showed an elastic soft, bordered mass behind the pancreatic head, duodenum, and hepatic colon flexure. No connection to the right kidney, ovarian vessels, or IVC was seen. We excised the tumor and an aberrant right renal artery branch. The 9.0×7.0×6.5 cm tumor, weighted 252 g, and consisted of a partially thickened wall and brownish serous fluid. Histopathologically, the wall consisted of mitotically inactive spindle cells reactive for SMA, desmin, and caldesmon, but not c-kit, S-100, CD34, CD99, EMA, or AE1/3 in immunohistochemical studies. The diagnosis was retroperitoneal leiomyoma with cystic degeneration.

Key words
retroperitoneum, leiomyoma, cyst

Reprint requests
Koichi Kato Department of Surgery II, Nagoya University Graduate School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
January 30, 2008

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