{"id":243,"date":"2018-08-30T07:43:23","date_gmt":"2018-08-30T07:43:23","guid":{"rendered":"https:\/\/blogs.bmj.com\/fg\/?p=243"},"modified":"2018-09-10T11:35:19","modified_gmt":"2018-09-10T11:35:19","slug":"incidental-retroperitoneal-tumour-a-rare-but-increasingly-common-diagnosis-with-an-excellent-prognosis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/fg\/2018\/08\/30\/incidental-retroperitoneal-tumour-a-rare-but-increasingly-common-diagnosis-with-an-excellent-prognosis\/","title":{"rendered":"A RARE BUT INCREASINGLY COMMON DIAGNOSIS WITH AN EXCELLENT PROGNOSIS"},"content":{"rendered":"<p>A 41 year-old lady, with no relevant medical or family history, presented with sharp right flank discomfort for 2 days and weight loss of 3 kilograms over 1 month. Aside from mild right flank tenderness, no other abnormality was noted on a multisystem clinical examination. She had normal leucocyte, hemoglobin, and liver function levels, a negative Hepatitis screen, and normal tumor markers (Alphafetoprotein, Cancer Antigen 19-9 and 125, Carcinoembryonic antigen). Urine metanephrines were not elevated. Computed Tomography (CT) and Primovist enhanced Magnetic Resonance Imaging (MRI) scans suggested a well-defined mass adjacent to the caudate lobe of the liver with arterial enhancement and no significant washout in the portal venous phase (Figures 1 and 2). She then underwent an exploratory laparotomy. A 7cm capsulated lesion in the retroperitoneum adjacent to the inferior vena cava and caudate lobe was identified and resected. The sliced specimen had a smooth, tan cut surface (Figure 3). Histopathological examination revealed an onion-skin appearance, and prominent vascular proliferation with hyalinised material (Figure 4). What is the diagnosis?<\/p>\n<p>&nbsp;<\/p>\n<p>Prajwala S <u>Prakash<\/u>1,\u00a0Frederick Hong Xiang <u>Koh<\/u>1,\u00a0Thomas Choudary<u>Putti<\/u>2, <u>Iyer<\/u>ShridharGanpathi1<\/p>\n<p>1 Division of Hepatobiliary&amp; Pancreatic Surgery, University Surgical Cluster, National University Hospital, Singapore<\/p>\n<h6>2 Department of Pathology, National University Hospital, Singapore<\/h6>\n<p><a href=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide3.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-245\" src=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide3-300x225.png\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide3-300x225.png 300w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide3-640x480.png 640w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide3.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a> <a href=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide4.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-246\" src=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide4-300x225.png\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide4-300x225.png 300w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide4-640x480.png 640w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide4.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a> <a href=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide5.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-247\" src=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide5-300x225.png\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide5-300x225.png 300w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide5-640x480.png 640w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide5.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a> <a href=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide6.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-248\" src=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide6-300x225.png\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide6-300x225.png 300w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide6-640x480.png 640w, https:\/\/blogs.bmj.com\/fg\/files\/2018\/08\/Slide6.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 41 year-old lady, with no relevant medical or family history, presented with sharp right flank discomfort for 2 days and weight loss of 3 kilograms over 1 month. Aside from mild right flank tenderness, no other abnormality was noted on a multisystem clinical examination. She had normal leucocyte, hemoglobin, and liver function levels, a [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/fg\/2018\/08\/30\/incidental-retroperitoneal-tumour-a-rare-but-increasingly-common-diagnosis-with-an-excellent-prognosis\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":308,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10257],"tags":[],"class_list":["post-243","post","type-post","status-publish","format-standard","hentry","category-fgcaseofthemonth"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A RARE BUT INCREASINGLY COMMON DIAGNOSIS WITH AN EXCELLENT PROGNOSIS - Frontline Gastroenterology Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/fg\/2018\/08\/30\/incidental-retroperitoneal-tumour-a-rare-but-increasingly-common-diagnosis-with-an-excellent-prognosis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A RARE BUT INCREASINGLY COMMON DIAGNOSIS WITH AN EXCELLENT PROGNOSIS - Frontline Gastroenterology Blog\" \/>\n<meta property=\"og:description\" content=\"A 41 year-old lady, with no relevant medical or family history, presented with sharp right flank discomfort for 2 days and weight loss of 3 kilograms over 1 month. 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