Preparation for CT of the retroperitoneal space with contrast. Contrast enhancement in computed tomography of the abdominal cavity, retroperitoneal space

When a lesion develops in a small organ, it can no longer be individualized, but a large sarcomatous tumor can "kill" the adrenals without causing it. Renal vein interruption may reflect the onset of leiomyosarcoma.

The main feeder artery of the tumor is important element in determining the origin of the lesion. The sensitivity and specificity of these different signs have not been clearly established. However, these semiological elements remain very useful in diagnostic development.

Clinically, semiology is poor. Pain or heaviness is present in 50% of cases by invasion or compression neighboring bodies. Symptomatology can be misleading and vary, truncate or predict pain. For example, neurological signs are present in 30% of cases and digestive signs are seen in 60% of cases, however, urinary involvement or venous constrictions are rare. These tumors are well tolerated by patients for a long time, and one patient in three suffers from a general condition.

The clinical examination perceives a retroperitoneal mass if it is bulky. Radiological reconnaissance becomes necessary to confirm the tumor, its retroperitoneal position, its primitive nature, and to guide the etiological diagnosis. There are radiological elements of focusing on the diagnosis of nature. First, frequency arguments, to which we will return.

Lymphangiomas and gangliononemas lie between normal structures. These tumors grow and expand between organs without compressing or invading them. Early diagnosis in children under 2 years of age, they are discovered incidentally and late in adults. Then they reached large sizes remaining completely asymptomatic. On various radiological studies, lymphangiomas appear as essentially cystic masses, united or multicellular, with sometimes a low course.

Paragangliomas lie along normal structures. Of sympathetic origin, ganglioneuromas have egg-shaped along sympathetic chains. When visualized, the specific density or characteristic signal of the tumor components allows you to focus on the diagnosis of nature.

A lesion with an exclusively fatty component is likely a lipoma. However, imaging does not rule out a small sarcomatous focus in the fat mass, and the diagnosis of lipoma should be made with caution. A lesion with mixed fat and tissue components is usually a liposarcoma. Liposarcoma is the most common retroperitoneal sarcoma. It has a histological variety ranging from well-differentiated sarcoma to undifferentiated sarcoma. The amount of intratumoral fat depends on tumor differentiation, some liposarcomas high class may not have macroscopically visible fat.

A large exoornal angiomyolipoma of the kidney is a complex differential diagnosis well-differentiated retroperitoneal liposarcoma. The presence of a renal connection associated with the presence of a bulky main dysplastic feeder artery in the mass is an argument in favor of the diagnosis of angiomyolipomas.

Teratomas may also have a fatty component. Mature teratomas are characterized by the presence of an association of fats, fluid areas, and calcifications or "ossification". The most effective radiological intelligence is a scanner. After injection of gadolinium chelate, enhancement is early and massive in malignant lesions, moderate or non-existent in benign masses.

It is found in large, high-dimensional malignant lesions such as leiomyosarcomas. This refers to cystic lymphangioma, an exclusively fluid or granular lesion. Neurogenic tumors are solid lesions containing cystic areas.

Lack of improvement classically witnesses a benign lesion: lipoma, lymphangioma, cyst. Bulk and early amplification contrast rather in favor of a malignant lesion if there is a "delayed wash". Thus, the degrees of amplification are very diverse, but retain the character of the orientation. However, there are important areas of overlap between benign lesions and malignant lesions.