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Retroperitoneal Metastases
Bryan R. Foster, MD; Matthew T. Heller, MD, FSAR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Retroperitoneal (RP)
          • Definitions

            • Spread of malignancy to RP lymph nodes and tissues

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Image-Guided Biopsy

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Naeem M et al: Imaging spectrum of granulomatous diseases of the abdomen and pelvis. Radiographics. 41(3):783-801, 2021
                                        2. Wang W et al: A 10-year observational single-center study of retroperitoneal unicentric Castleman disease. Medicine (Baltimore). 100(10):e25088, 2021
                                        3. Barbosa FG et al: Revisiting prostate cancer recurrence with PSMA PET: atlas of typical and atypical patterns of spread. Radiographics. 39(1):186-212, 2019
                                        4. Magudia K et al: Unusual imaging findings associated with germ cell tumors. Radiographics. 39(4):1019-35, 2019
                                        5. Touloumis Z et al: Retroperitoneal perivascular epithelioid cell tumours: a case report and review of literature. World J Clin Cases. 7(21):3524-34, 2019
                                        6. Paño B et al: Pathways of lymphatic spread in gynecologic malignancies. Radiographics. 35(3):916-45, 2015
                                        7. Dauwen H et al: PET/CT in the staging of patients with a pelvic mass suspicious for ovarian cancer. Gynecol Oncol. 131(3):694-700, 2013
                                        8. Eberhardt SC et al: Oncology imaging in the abdomen and pelvis: where cancer hides. Abdom Imaging. 38(4):647-71, 2013
                                        9. Osman S et al: A comprehensive review of the retroperitoneal anatomy, neoplasms, and pattern of disease spread. Curr Probl Diagn Radiol. 42(5):191-208, 2013
                                        10. Goenka AH et al: Imaging of the retroperitoneum. Radiol Clin North Am. 50(2):333-55, vii, 2012
                                        11. Heller MT et al: Neoplastic and proliferative disorders of the perinephric space. Clin Radiol. 67(11):e31-41, 2012
                                        12. Avila NA et al: Imaging features of lymphangioleiomyomatosis: diagnostic pitfalls. AJR Am J Roentgenol. 196(4):982-6, 2011
                                        13. Paño B et al: Pathways of lymphatic spread in male urogenital pelvic malignancies. Radiographics. 31(1):135-60, 2011
                                        14. Besse B et al: Nonseminomatous germ cell tumors: assessing the need for postchemotherapy contralateral pulmonary resection in patients with ipsilateral complete necrosis. J Thorac Cardiovasc Surg. 137(2):448-52, 2009
                                        15. Ross RW et al: Lymphotropic nanoparticle-enhanced magnetic resonance imaging (LNMRI) identifies occult lymph node metastases in prostate cancer patients prior to salvage radiation therapy. Clin Imaging. 33(4):301-5, 2009
                                        16. Sohaib SA et al: Prospective assessment of MRI for imaging retroperitoneal metastases from testicular germ cell tumours. Clin Radiol. 64(4):362-7, 2009
                                        17. Boran N et al: A retrospective analysis of the diameter of metastatic lymph nodes in apparently early stage endometrial cancer. Tumori. 94(5):681-5, 2008
                                        18. Casey RG et al: A prospective 10 year audit of a single Irish centre's experience of retroperitoneal lymph node dissection for metastatic testis cancer. Surgeon. 6(5):294-6, 2008
                                        19. Sharp DS et al: Clinical outcome and predictors of survival in late relapse of germ cell tumor. J Clin Oncol. 26(34):5524-9, 2008
                                        20. Nishino M et al: Primary retroperitoneal neoplasms: CT and MR imaging findings with anatomic and pathologic diagnostic clues. Radiographics. 23(1):45-57, 2003
                                        21. Pallisa E et al: Lymphangioleiomyomatosis: pulmonary and abdominal findings with pathologic correlation. Radiographics. 22 Spec No:S185-98, 2002
                                        22. Avila NA et al: Lymphangioleiomyomatosis: abdominopelvic CT and US findings. Radiology. 216(1):147-53, 2000
                                        23. Vesselle HJ et al: FDG PET of the retroperitoneum: normal anatomy, variants, pathologic conditions, and strategies to avoid diagnostic pitfalls. Radiographics. 18(4):805-23; discussion 823-4, 1998
                                        24. Hilton S et al: CT detection of retroperitoneal lymph node metastases in patients with clinical stage I testicular nonseminomatous germ cell cancer: assessment of size and distribution criteria. AJR Am J Roentgenol. 169(2):521-5, 1997
                                        25. Jeffrey RB Jr et al: Abdominal CT in acquired immunodeficiency syndrome. AJR Am J Roentgenol. 146(1):7-13, 1986
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Retroperitoneal (RP)
                                                • Definitions

                                                  • Spread of malignancy to RP lymph nodes and tissues

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Image-Guided Biopsy

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Naeem M et al: Imaging spectrum of granulomatous diseases of the abdomen and pelvis. Radiographics. 41(3):783-801, 2021
                                                                              2. Wang W et al: A 10-year observational single-center study of retroperitoneal unicentric Castleman disease. Medicine (Baltimore). 100(10):e25088, 2021
                                                                              3. Barbosa FG et al: Revisiting prostate cancer recurrence with PSMA PET: atlas of typical and atypical patterns of spread. Radiographics. 39(1):186-212, 2019
                                                                              4. Magudia K et al: Unusual imaging findings associated with germ cell tumors. Radiographics. 39(4):1019-35, 2019
                                                                              5. Touloumis Z et al: Retroperitoneal perivascular epithelioid cell tumours: a case report and review of literature. World J Clin Cases. 7(21):3524-34, 2019
                                                                              6. Paño B et al: Pathways of lymphatic spread in gynecologic malignancies. Radiographics. 35(3):916-45, 2015
                                                                              7. Dauwen H et al: PET/CT in the staging of patients with a pelvic mass suspicious for ovarian cancer. Gynecol Oncol. 131(3):694-700, 2013
                                                                              8. Eberhardt SC et al: Oncology imaging in the abdomen and pelvis: where cancer hides. Abdom Imaging. 38(4):647-71, 2013
                                                                              9. Osman S et al: A comprehensive review of the retroperitoneal anatomy, neoplasms, and pattern of disease spread. Curr Probl Diagn Radiol. 42(5):191-208, 2013
                                                                              10. Goenka AH et al: Imaging of the retroperitoneum. Radiol Clin North Am. 50(2):333-55, vii, 2012
                                                                              11. Heller MT et al: Neoplastic and proliferative disorders of the perinephric space. Clin Radiol. 67(11):e31-41, 2012
                                                                              12. Avila NA et al: Imaging features of lymphangioleiomyomatosis: diagnostic pitfalls. AJR Am J Roentgenol. 196(4):982-6, 2011
                                                                              13. Paño B et al: Pathways of lymphatic spread in male urogenital pelvic malignancies. Radiographics. 31(1):135-60, 2011
                                                                              14. Besse B et al: Nonseminomatous germ cell tumors: assessing the need for postchemotherapy contralateral pulmonary resection in patients with ipsilateral complete necrosis. J Thorac Cardiovasc Surg. 137(2):448-52, 2009
                                                                              15. Ross RW et al: Lymphotropic nanoparticle-enhanced magnetic resonance imaging (LNMRI) identifies occult lymph node metastases in prostate cancer patients prior to salvage radiation therapy. Clin Imaging. 33(4):301-5, 2009
                                                                              16. Sohaib SA et al: Prospective assessment of MRI for imaging retroperitoneal metastases from testicular germ cell tumours. Clin Radiol. 64(4):362-7, 2009
                                                                              17. Boran N et al: A retrospective analysis of the diameter of metastatic lymph nodes in apparently early stage endometrial cancer. Tumori. 94(5):681-5, 2008
                                                                              18. Casey RG et al: A prospective 10 year audit of a single Irish centre's experience of retroperitoneal lymph node dissection for metastatic testis cancer. Surgeon. 6(5):294-6, 2008
                                                                              19. Sharp DS et al: Clinical outcome and predictors of survival in late relapse of germ cell tumor. J Clin Oncol. 26(34):5524-9, 2008
                                                                              20. Nishino M et al: Primary retroperitoneal neoplasms: CT and MR imaging findings with anatomic and pathologic diagnostic clues. Radiographics. 23(1):45-57, 2003
                                                                              21. Pallisa E et al: Lymphangioleiomyomatosis: pulmonary and abdominal findings with pathologic correlation. Radiographics. 22 Spec No:S185-98, 2002
                                                                              22. Avila NA et al: Lymphangioleiomyomatosis: abdominopelvic CT and US findings. Radiology. 216(1):147-53, 2000
                                                                              23. Vesselle HJ et al: FDG PET of the retroperitoneum: normal anatomy, variants, pathologic conditions, and strategies to avoid diagnostic pitfalls. Radiographics. 18(4):805-23; discussion 823-4, 1998
                                                                              24. Hilton S et al: CT detection of retroperitoneal lymph node metastases in patients with clinical stage I testicular nonseminomatous germ cell cancer: assessment of size and distribution criteria. AJR Am J Roentgenol. 169(2):521-5, 1997
                                                                              25. Jeffrey RB Jr et al: Abdominal CT in acquired immunodeficiency syndrome. AJR Am J Roentgenol. 146(1):7-13, 1986