A Nine Years Histopathological Retrospective Study of Retroperitoneal Masses

Abstract

Introduction: Retroperitoneum is potentially large space that allows both primary and metastatic tumours to grow silently before clinical signs and symptoms appear. However, retroperitoneal masses due to their uninhibited growth and with no facial boundaries they are often attain large size before the development of symptoms and the establishment of a diagnosis. There are a vast number of neoplasms occurring in this region. Understanding the pathology and lesions is important, for early diagnosis and for treatment of these neoplasms. Aim: To study the overall prevalence of primary and secondary retroperitoneal neoplasms and the varied histomorphological spectrum of retroperitoneal masses. Also to categorise the lesions as benign and malignant tumors of retroperitoneum. Materials and Methods: This retrospective study was conducted in the Department of Pathology, Karnataka Institute of Medical Sciences Hubballi, Karnataka, India from 2011 to 2019. A total of 39,757 specimens were recieved to histopathology section during this period. Among them, 53 (0.13%) were retroperitoneal tumours. Haematoxylin and Eosin (H&E) stained slides were thoroughly analysed and categorised into non neoplastic, benign and malignant tumours. Further, based on the finer microscopic features, the accurate subtype of the tumour type was made. The descriptive statistics like mean, range and percentage are used. Results: Total 53 cases of retroperitoneal tumours were studied of which 10 (18.9%) cases were primary retroperitoneal masses and 43 (81.1%) cases were secondary retroperitoneal masses. Mean age was 40.7 years with male to female ratio 1.5:1. Malignant lesions were more common accounting to 50.94% cases, followed by benign 22.64% cases, the rest were intermediate grade and inflammatory. Kidney lesions were most common secondary retroperitoneal masses, accounting for 41.5% cases, followed by pancreas 22.64% cases, adrenals 13.20% cases and Lymphnodes 3.7% cases. Primary retroperitoneal masses which accounted for 18.9% cases were categorised histomorphologically as spindle cell tumours, adipocytic, small round cell tumours, cartilaginous origin and cystic lesions. Conclusion: Diagnosis of retroperitoneal tumours is challenging due to their varied histomorphology and histopathology forms the gold standard for diagnosis.

Keywords

• retroperitoneum
• secondary neoplasms
• spindle cell tumours