Giant retroperitoneal myxoma: A case report and literature review

Our plain-English summary of Giant retroperitoneal myxoma: A case report and literature review, by Z. Zhang, L. Song, X. Zhu, et al (International Journal of Surgery Case Reports, 2021).

The study

• Authors: Z. Zhang, L. Song, X. Zhu, Z. Huang, J. Chen, Q. Zeng
• Journal: International Journal of Surgery Case Reports
• Published: 2021;84:106055
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction And Importance: Myxoma is a benign tumor and is mesenchymal in origin. Myxomas of the retroperitoneum are extremely rare entities.

Case Presentation: We here report a case of a 67-year-old male who presented with progressive abdominal distention for 3 years. Laboratory investigations revealed a reduction in erythrocytes, lymphocytes, hemoglobin, and an elevation in carbohydrate antigen 19-9. Imaging findings showed a multilocular cystic mass in the right abdomen with thin septa and internal calcifications. Laparotomy revealed that the mass had arisen from the retroperitoneum and the histological study suggested the diagnosis of myxoma.

Discussion: Myxoma features as a "cystic mass" in imaging studies. Therefore, the possibility of a cystic lymphangioma, cystic mesothelioma and myxoma should be considered when a multicystic lesion in the retroperitoneal space is observed. Due to the rarity of retroperitoneal myxomas and lack of specific manifestations and diagnostic methods, preoperative diagnosis is often delayed or incorrect. And until now, only a few cases of retroperitoneal myxoma have been reported.

Conclusion: The report will increase the understanding of the diagnosis and treatment of retroperitoneal myxomas. A brief review of the related literature was also carried out.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

In plain English

This article was a case report with a brief literature review, written by radiologists in Guiyang, China. It described a 67-year-old man who came to hospital with abdominal swelling that had grown worse over 3 years. Ten years earlier he had surgery for a retroperitoneal tumor, and he had smoked for more than 40 years. The article does not mention asbestos. A CT scan showed a large cystic mass with many compartments, measuring 35 × 24 × 13 cm, in the retroperitoneum, the space at the back of the abdomen. Before surgery, doctors considered cystic lymphangioma, cystic mesothelioma or a rare myxoma, and leaned toward lymphangioma. The mass was removed completely. Tissue examination showed a low-grade myxoma, a benign tumor, with part of the lesion of high grade. A blood marker, CA19-9, was raised at 594.5 U/mL. A clot was found in the inferior vena cava. The patient had complications including pulmonary embolism and cerebral infarction, and he died of septic shock. The authors concluded that radiologists should consider cystic lymphangioma, cystic mesothelioma and myxoma when they see cystic masses in this space. Mesothelioma appears in this article only as a possible alternative diagnosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report with a brief literature review
• Who was studied: one 67-year-old man seen at the authors' hospital (the Affiliated Hospital of Guizhou Medical University, Guiyang, China, per the author affiliations); the date of treatment is not given
• Exposure: No asbestos or other occupational exposure is mentioned. The only exposure history given is smoking for more than 40 years, along with prior surgery for a retroperitoneal tumor ten years earlier.
• Main results:
  • CT showed a large, well-circumscribed multilocular cystic mass measuring 35 × 24 × 13 cm
  • Based on imaging, cystic lymphangioma, cystic mesothelioma or a rare retroperitoneal myxoma were considered; the preoperative diagnosis favored retroperitoneal lymphangioma
  • Histopathology was consistent with a low-grade myxoma; atypia and mitotic activity were infrequent, and part of the lesion was high grade
  • In this patient, carbohydrate antigen 19-9 was raised at 594.5 U/mL, and lymphocytes were low at 0.49 × 10^9/L (reference 1.1 to 3.2)
  • The mass arose from the retroperitoneum and was completely excised; a thrombus was found in the inferior vena cava
  • The patient had complications including pulmonary embolism and cerebral infarction, and died of septic shock
• The authors' conclusion: The authors concluded that radiologists should keep cystic lymphangioma, cystic mesothelioma and myxoma in mind as possible diagnoses when they find retroperitoneal cystic lesions.

Topics

Medical terms in this study, explained in our Lexicon: Retroperitoneum, Laparotomy, Mesothelioma.

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