|Year : 1995 | Volume
| Issue : 6 | Page : 139-141
Primary retroperitoneal tumours a 25 year study
Muktha R Pai, Ramadas Naik, CV Raghuveer
Department of Pathology, Kasturba Medical College, Mangalore-575 001, India
|Date of Submission||07-Nov-1994|
Muktha R Pai
Department of Pathology, Kasturba Medical College, Mangalore-575 001
|How to cite this article:|
Pai MR, Naik R, Raghuveer C V. Primary retroperitoneal tumours a 25 year study. Indian J Med Sci 1995;49:139-41
Primary tumours of the retroperitoneum are not common entities. Over a period of 25 years only 34 such tumours were encountered by us. Germ cell tumours accounted for the largest number (15) followed by soft tissue tumours (10) and tumours of sympathetic nervous system (9). Majority of the tumours were malignant. Owing to the extensive area, any tumour in the retroperitoneum can grow unnoticed for a long time.  Hence its early detection has considerable clinical significance. The pathological diagnosis is extremely important for proper patient management.
| ¤ Material and Methods|| |
In the present study 34 retroperitoneal tumours were analysed. Tissue sections were stained by haematoxylin and eosin and wherever appropriate special stains were employed.
| ¤ Results|| |
Out of the 34 cases, 15 (44.1 %) were germ cell tumours. Teratomas constituted the commonest germ cell tumours (11 out of 15), 2 of these being immature teratomas followed by embrayonal carcinoma and dysgerminoma (2 each). Most of the germ cell tumours (14 out of 15) occurred in children with a female preponderance M:F = 1:2. There were 10 cases of soft tissue tumours constituting 29.4% of all retroperitoneal tumours. Majority of them were sarcomas (9 out of 10 i.e. 90%). There were 5 liposarcomas, 3 leiomyosarcomas and 1 neurogenic sarcoma. The only benign soft tissue tumour was a lipoma. Tumours of the sympathetic nervous system constituted 9 out of 34 cases (26.5%). Out of them 7 were neuroblastomas while 2 showed evidence of maturation to ganglioneuroblastoma. These tumours were mostly seen in children and young adults.
| ¤ Discussion|| |
Retroperitoneal tumours are rather uncommon.  Approximately 80% of them are malignant with distant metastases in 1/3 of the patients at diagnosis.  In the present series also 24 out of 34 cases (70.6%) were malignant tumours. Primary retroperitoneal extragonadal germ cell tumours are very uncommon in children , and in the adults too accurrence of germ cell tumours in the retroperitoneum is more likely to be a metastatic deposit of a primary gonadal tumour. Among the retroperitoneal germ cell tumours in children, teratomas are most common.  In the present study 73.3% (11 out of 15) of the germ cell tumours were teratomas. Mature teratomas are generally cystic with mural nodules. Presence of teeth and bony structures helps their early detection by X-ray. In the present study 73.3% (11 out of 15) of the germ cell tumours were teratomas. Mature teratomas are generally cystic with mural nodules. Presence of teeth and bony structures helps their early detection by X-ray. In the present series 3 of the teratomas deserve special mention - 2 showed tumour masses with attached limb buds ('fetus in fetu') and the other showed prostatic tissue on microscopic examination besides other teratomatous elements. Fetus in fetu is an interesting variant of retroperitoneal teratoma.  Since majority of the teratomas are benign, complete resection of the tumour might ensure adequate cure. As a group retroperitoneal sarcomas have poor prognosis. The main reason being the great difficulty in their complete surgical removal.  Tumour debulking followed by radiation seems to be the treatment of choice.  Tumours of the sympathetic nervous system like neuroblastoma and ganglioneuroblastomas in the retroperitoneum are slow growing tumours.  Surgery followed by radiotherapy is useful in their management.
| ¤ Summary|| |
Primary retroperitoneal neoplasia is not a common condition. Out of the 34 tumours analysed in the present study 15 were germ cell tumours, 10 were soft tissue tumours and 9 were tumours of the sympathetic nervous system. Among the 15 germ cell tumours, 9 were mature teratomas while there were 2 each of immature teratoma, embrayonal carcinoma and dysgerminoma. Out of the 10 soft tissue tumours 9 were sarcomas with 5 liposarcomas, 3 leiomyosarcomas and 1 neurogenic sarcoma. The only benign soft tissue tumour was a lipoma. The 9 tumours of the sympathetic nervous system included 7 neuroblastornas and 2 ganglioneuroblastomas. Overall, in the present series majority of the primary retroperitoneal tumours (22 out of 34 i.e. 70.6%) were malignant tumours.
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