Wilms' tumor is the most common malignant abdominal tumor in the adolescent and pediatric period, whereas adult Wilms' tumor is uncommon. Wilms' tumor often originates in the kidney. Extrarenal Wilms' tumor is rare and has been considered "unstageable". Therefore, treatment and long-term survival have not been uniformly reported. We report a 24 year-old female who developed extrarenal Wilms' tumor, in the retroperitoneal space. She was misdiagnosed for ovarian neoplasm and underwent debulking operation, by which Wilms' tumor was confirmed. Palliative chemotherapy and radiotherapy were performed.
Adolescent ; Adult* ; Drug Therapy ; Female ; Humans ; Kidney ; Ovarian Neoplasms ; Radiotherapy ; Retroperitoneal Space ; Wilms Tumor* ; Young Adult

To develop a more appropriate therapeutic strategy for treatment of nonpulmonary visceral metastatic testicular seminoma based on the International Germ Cell Consensus Classification, we reviewed the medical records of patients with nonpulmonary visceral metastatic testicular seminoma who were treated over a 20-year period. Only 15 (2.2%) of the 686 cases of testicular seminoma were nonpulmonary visceral metastatic seminoma. The median age of patients was 38 years (range, 22-53 years). Ten (67%) of the patients had an initial diagnosis of supradiaphragmatic or visceral metastatic disease. In addition to nonpulmonary visceral metastasis, all patients had lymph node metastasis as well, the majority of which involved the retroperitoneal lymph nodes. The median and mean progression-free survival durations after chemotherapy for advanced disease were 19 months and 63.7 months, respectively. Six patients (40%) survived, five relapsed after radiation therapy and four died of chemorefractory disease not dependent on the specific regimen. Although the number of cases reviewed in this study was small, we conclude that the choice of chemotherapeutic regimen among the current treatments for nonpulmonary visceral metastatic seminoma of testis primary does not present a different outcome. Therefore, multimodality therapies using new strategies or new agents are well indicated.
Adult ; Antineoplastic Agents, Combined/administration & dosage* ; Bone Neoplasms/secondary ; Bone Neoplasms/radiotherapy ; Bone Neoplasms/drug therapy ; Combined Modality Therapy ; Human ; Lung Neoplasms/secondary ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/drug therapy ; Lymphatic Metastasis ; Male ; Middle Age ; Retroperitoneal Neoplasms/secondary* ; Retroperitoneal Neoplasms/radiotherapy ; Retroperitoneal Neoplasms/drug therapy* ; Retrospective Studies ; Seminoma/secondary* ; Seminoma/radiotherapy ; Seminoma/drug therapy* ; Testicular Neoplasms/pathology*

Extramedullary plasmacytoma is an uncommon neoplasm and it occurs most frequently in the upper respiratory tract. Among the extramedullary plasmacytomas, retroperitoneal plasmacytoma is an extremely rare tumor with only about 10 cases having been reported in the world. Herein, we reported on a extramedullary plasmacytoma in the retroperitoneum. A 68-year-old man presented with left flank pain. The initial clinical diagnosis was retroperitoneal tumor. Retroperitoneal tumor mass excision along with left nephrectomy was performed and the histopathology showed plasmacytoma. There was no evidence of multiple myeloma. After the operation, he was treated with radiotherapy and the out-patient department follow-up is going on.
Aged ; Diagnosis ; Flank Pain ; Follow-Up Studies ; Humans ; Multiple Myeloma ; Nephrectomy ; Outpatients ; Plasmacytoma* ; Radiotherapy ; Respiratory System ; Retroperitoneal Neoplasms

A complete surgical resection is the only proven therapeutic modality that prolongs the survival in patients with leiomyosarcoma of the inferior vena cava (IVC). Reconstruction of the IVC is not always necessary but is often required to facilitate venous drainage of the kidney for the tumors at the pararenal area of the IVC. Controversy exists in postoperative adjuvant therapy. Recently, we experienced four cases of pararenal leiomyosarcoma of the IVC, of which treatment consisted of a complete resection of the tumor, ringed polytetrafluoroethylene (PTFE) graft interposition, and bilateral renal vein reconstructions in all patients. Postoperative radiation therapy was instituted in 3 of 4 patients. One patient who did not receive the postoperative radiation therapy was treated with adjuvant chemotherapy. The kidneys were preserved in all patients and no deep vein thrombosis (DVT) or venous insufficiency of the lower extremity veins developed. Distant metastasis to the lung was noted in one patient at 18 months after surgery, who was not received the postoperative radiation therapy but chemotherapy. In conclusion, a complete resection of the tumor, IVC reconstruction, and bilateral renal vein reconstruction followed by adjuvant radiation therapy is recommended for the treatment of pararenal leiomyosarcoma of the IVC.
Adult ; Combined Modality Therapy ; Female ; Human ; Leiomyosarcoma/radiography/*radiotherapy/*surgery ; Middle Aged ; Neoplasm Recurrence, Local/radiography/radiotherapy/surgery ; Retroperitoneal Neoplasms/radiography/radiotherapy/surgery ; Retrospective Studies ; Treatment Outcome ; Vascular Neoplasms/radiography/*radiotherapy/*surgery ; *Vena Cava, Inferior

A 74-year-old postmenopausal woman visited our gynecology clinic complaining of a palpable abdominal mass. Physical and radiological evaluation indicated that the mass exhibited features of a left ovarian neoplasm showing heterogeneous enhancement. Surgical resection was performed to confirm this suspicion. During surgery, a mass was observed only in the left ovary with no invasive growth, but adhesions to the surrounding peritoneum were seen. Given the patient's age, large mass size, and accompanying uterine myoma and right ovarian cyst, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The final pathologic diagnosis was dedifferentiated liposarcoma. The liposarcoma was suspected to originate from retroperitoneal adipose tissue rather than the ovary. Radiotherapy was planned if a gross lesion indicating recurrence followed 6 months later. This case required a considerable multi-disciplinary approach for diagnosis and treatment because of its ambiguous clinical and radiological findings.
Aged ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Intra-Abdominal Fat ; Leiomyoma ; Liposarcoma* ; Ovarian Cysts ; Ovarian Neoplasms ; Ovary ; Peritoneum ; Radiotherapy ; Recurrence ; Retroperitoneal Neoplasms

No abstract available.
Aged ; Biopsy ; Chemotherapy, Adjuvant ; Colectomy ; Colonic Neoplasms/*pathology/therapy ; Humans ; Liposarcoma/*pathology/therapy ; Male ; Neoplasms, Second Primary/*pathology/therapy ; Radiotherapy, Adjuvant ; Retroperitoneal Neoplasms/*pathology/therapy ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo study the proper way of using combined postoperative chemo-radiotherapy and prognostic factors of soft tissue sarcoma.

METHODSThe clinical data of 184 patients were retrospectively reviewed. These patients were devided into surgery group (S, 94 patients), surgery plus postoperative radiotherapy group (S + R, 62 patients) and surgery plus chemotherapy group (S + C, 28 patients).

RESULTSThe 5-year survival rates of S, S + R and S + C groups were 39.4%, 48.4% and 28.6%, respectively. Combined multitherapy was the key to improve survival rate and life quality. Clinical stage, pathological type and therapeutic method were also important prognostic factors for the long term survival.

CONCLUSIONSurgery plus postoperative radiotherapy can improve the 5-year survival rate of soft tissue sarcoma.

Adolescent ; Adult ; Age Factors ; Aged ; Chemotherapy, Adjuvant ; Child ; Child, Preschool ; Dermatofibrosarcoma ; mortality ; secondary ; therapy ; Female ; Follow-Up Studies ; Humans ; Liposarcoma ; mortality ; secondary ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Retroperitoneal Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies ; Skin Neoplasms ; mortality ; pathology ; therapy ; Soft Tissue Neoplasms ; mortality ; pathology ; therapy ; Survival Rate

OBJECTIVETo investigate the diagnosis and treatment of malignant fibrous histiocytoma of the retroperitoneum (MFHR).

METHODSThe clinicopathological features, treatment and prognosis of 31 patients with MFHR were retrospectively analyzed.

RESULTSThe mean age of the patients was 52.7 +/- 14.1 years. Male:Female = 22:9. The primary symptoms were abdominal mass and pain. The average diameter of tumor was 15 cm. The histopathologic types of the tumor were inflammatory, storiform-pleomorphic, myxoid and giant cell in 16, 10, 4 and 1 cases. The overall survival rate of 1-, 3- and 5-year was 61.3% +/- 9.8%, 31.6% +/- 11.3% and 21.1% +/- 11.4% with a median survival time of 17.0 +/- 6.3 months. Complete resection of the tumor was the major prognostic factor. Postoperative radiotherapy of 20 - 45 Gy was able to prolong the median survival from 12.1 +/- 11.6 months of surgery alone to 26.4 +/- 22.0 months of surgery plus postoperative radiotherapy though without statistical significance (P = 0.051). Postoperative CHOP chemotherapy was not shown to be beneficial.

CONCLUSIONChemotherapy remains the important method of cure. The survival in patients with MFHR might be improved by complete resection combined with chemotherapy or/and radiotherapy.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Chemotherapy, Adjuvant ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Female ; Follow-Up Studies ; Histiocytoma, Benign Fibrous ; secondary ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pancreatectomy ; Postoperative Period ; Prednisone ; administration & dosage ; Prognosis ; Radiotherapy, Adjuvant ; Retroperitoneal Neoplasms ; pathology ; surgery ; therapy ; Retrospective Studies ; Splenectomy ; Survival Rate ; Vincristine ; administration & dosage