Sexual disorders following retroperitoneal pelvic lymph node dissection (RPLND) for testis tumor can affect the quality of life of patients. The aim of the current study was to investigate several different andrological outcomes, which may be influenced by robot-assisted (RA) RPLND. From January 2012 to March 2020, 32 patients underwent RA-RPLND for stage I nonseminomatous testis cancer or postchemotherapy (PC) residual mass. Modified unilateral RPLND nerve-sparing template was always used. Major variables of interest were erectile dysfunction (ED), premature ejaculation (PE), dry ejaculation (DE), or orgasm alteration. Finally, fertility as well as the fecundation process (sexual intercourse or medically assisted procreation [MAP]) was investigated. Ten patients (31.3%) presented an andrological disorder of any type after RA-RPLND. Hypospermia was present in 4 (12.5%) patients, DE (International Index of Erectile Function-5 [IIEF-5] <25) in 3 (9.4%) patients, and ED in 3 (9.4%) patients. No PE or orgasmic alterations were described. Similar median age at surgery, body mass index (BMI), number of nodes removed, scholar status, and preoperative risk factor rates were identified between groups. Of all these 10 patients, 6 (60.0%) were treated at the beginning of our robotic experience (2012-2016). Of all 32 patients, 5 (15.6%) attempted to have a child after RA-RPLND. All of these 5 patients have successfully fathered children, but 2 (40.0%) required a MAP. In conclusion, a nonnegligible number of andrological complications occurred after RA-RPLND, mainly represented by ejaculation disorders, but ED occurrence and overall sexual satisfaction deficit should be definitely considered. No negative impact on fertility was described after RA-RPLND.
Male ; Child ; Humans ; Robotics ; Quality of Life ; Retrospective Studies ; Neoplasms, Germ Cell and Embryonal/surgery* ; Testicular Neoplasms/pathology* ; Lymph Node Excision/adverse effects* ; Retroperitoneal Space/surgery* ; Erectile Dysfunction/surgery* ; Treatment Outcome

Humans ; Liposarcoma/surgery* ; Retroperitoneal Neoplasms/pathology* ; STAT6 Transcription Factor

The incidence of retroperitoneal tumor is low, and treatment is difficult.According to the recent updates of evidence-based medical evidence at home and abroad, the consensus on the standardized treatment of retroperitoneal tumors were discussed including examination and diagnosis , surgical treatment comprehensive treatment, nutrition, rehabilitation, and review and follow-up, etc.
Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; China ; Consensus ; Delivery of Health Care ; standards ; Humans ; Practice Guidelines as Topic ; Retroperitoneal Neoplasms ; diagnosis ; drug therapy ; pathology

Acute Kidney Injury ; diagnostic imaging ; etiology ; Aged ; Humans ; Male ; Necrosis ; diagnostic imaging ; etiology ; Paraganglioma ; complications ; Postoperative Complications ; Retroperitoneal Neoplasms ; complications ; Skin ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective: To report a rare case of epididymal liposarcoma with multiple metastases to the retroperitoneal space and peritoneal cavity for the purpose of improving the diagnosis and treatment of the disease. METHODS: We retrospectively analyzed the clinical data about a case of epididymal liposarcoma with multiple metastases to the retroperitoneal space and peritoneal cavity, reviewed relevant literature at home and abroad, and investigated the presentation, diagnosis and treatment of the disease. RESULTS: A 47-year-old male patient with epididymal liposarcoma underwent radical left orchiectomy with high ligation of the spermmatic cord. Ten years later, recurrence and metastasis were observed in the retroperitoneal space with a mass of 15.6 × 9.4 × 25.5 cm occupying an area from the upper pole of the left kidney to the pelvic cavity and enclosing the left kidney and upper ureter, for which the patient received radical resection of the retroperitoneal tumor. However, multiple retroperitoneal and intraperitoneal metastases occurred again 4 years later, which was treated by another surgical resection. The patient died of lung failure a year later. CONCLUSIONS Epididymal liposarcoma is a rare entity, which can be diagnosed by careful clinical and radiological examinations and confirmed by pathology. For its treatment, radical inguinal orchiectomy should be performed as early as possible, but the roles of adjuvant radiotherapy and chemotherapy remain controversial. Given the high rate of recurrence and metastasis, long-term follow-up is necessitated for the patient postoperatively.
Epididymis ; pathology ; Genital Neoplasms, Male ; pathology ; Humans ; Kidney ; Liposarcoma ; pathology ; secondary ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Orchiectomy ; Peritoneal Cavity ; Peritoneal Neoplasms ; secondary ; Retroperitoneal Neoplasms ; secondary ; Retroperitoneal Space

A 56-year-old female was referred to our hospital due to a mass measuring 5 cm in size in the left pelvic cavity, which was found incidentally during a health examination by ultrasonography. Exploratory laparotomy was performed and the mass was located at the left retroperitoneal parametrium without invasion of the uterus and ovary. The pathology report confirmed squamous cell carcinoma. Even after further studies, we did not find any other primary lesion. Human papillomavirus (HPV) DNA chip test (HPV 9G DNA Membrane Kit, Biometrixtechnology Inc.) showed that the surgical specimen was positive for HPV 18. She received adjuvant chemotherapy and would receive radiation therapy for the possibility of occult gynecologic cancer. Retroperitoneal squamous cell carcinoma of unknown primary is extremely rare and little is known about it. It is reported that HPV may be associated with the disease. Hence, the result of HPV test could have an impact on finding a suspicious primary lesion and treatment modality in this case.
Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; DNA ; Female ; Human papillomavirus 18 ; Humans ; Laparotomy ; Membranes ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Ovary ; Pathology ; Retroperitoneal Neoplasms ; Ultrasonography ; Uterus

OBJECTIVETo evaluate the CT and MR findings of retroperitoneal ectopic pheochromocytoma.

METHODSTo analyze retrospectively the CT and MR images of 32 patients with retroperitoneal ectopic pheochromocytoma proved by pathology.

RESULTSThe lesions (benign=28, malignant=4) were located in the anterior pararenal space (ARS) (n=12), the perirenal space (PS) (n=13) and the posterior pararenal space (PRS) (n=7). The tumors showed heterogeneous density on unenhanced CT (n=25). Among the 23 cases with enhanced CT imaging, 19 cases had marked contrast and 4 had mild contrast. The enhancement patterns included whole enhancement (n=9), solid area enhancement (n=12), peripheral enhancement (n=1), and spotted enhancement (n=1). The tumors had heterogeneous signal on unenhanced MR (n=23), and usually showed enhancement at arterial, portal and delayed phases on 22 enhanced MR, while cystic area with no enhancement. The lesions usually had cystic changes (n=18), septa (n=16), vessels inside (n=9), hemorrhage (n=3), and calcification (n=3). Besides that the morphology had statistical significance (P=0.013), other indexes had no statistical significance (P>0.05) in differential diagnosis of benign and malignant retroperitoneal ectopic pheochromocytomas.

CONCLUSIONSRetroperitoneal ectopic pheochromocytomas have some CT and MR features, usually revealed as an oval mass, growing along the paravertebral axis, and often with cystic changes. Those signs combined with hypertension and elevated catecholamine level may lead to a correct diagnosis.

Adrenal Gland Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; Diagnosis, Differential ; Humans ; Hypertension ; Image Enhancement ; Pheochromocytoma ; diagnostic imaging ; pathology ; Retroperitoneal Space ; Retrospective Studies ; Tomography, X-Ray Computed

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 explore the clinical characteristics, diagnosis and treatment regimens for retroperitoneal schwannoma.

METHODSClinicopathological data of 53 retroperitoneal schwannoma patients treated from January 1999 to April 2013 in our hospital were collected and analyzed using SPSS 13.0 statistical software.

RESULTSSymptoms of the retroperitoneal schwannoma were vague and nonspecific. 12 patients had interrupted abdominal pain, 9 patients had abdominal discomfort, and only 6 patients presented with abdominal mass while 24 patients were detected by health checkup. There were some characteristics but not specific findings in imaging examination such as CT, ultrasonography and MRI, so preoperative diagnosis rate was low with only 9 patients diagnosed as retroperitoneal schwannoma and 21 patients diagnosed as neurogenic tumor. S-100 immunohistochemisty was very important in pathological diagnosis, and the patients with benign retroperitoneal schwannoma got 100% tumor specific 5-year survival after complete excision while the 5-year survival of malignant retroperitoneal schwannoma was only 50.0%.

CONCLUSIONSRetroperitoneal schwannoma is a rare disease. Most of them are benign tumors, and complete surgical excision is the effective treatment.

Abdominal Pain ; Diagnostic Imaging ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma ; diagnosis ; pathology ; therapy ; Physical Examination ; Retroperitoneal Neoplasms ; diagnosis ; pathology ; therapy ; Retroperitoneal Space ; Treatment Outcome

A 51-year-old male patient was presented to our hospital for inspection of right renal space-occupying lesions. CT revealed soft tissue density in the right renal pelvis and renal pelvis ureter transitional crumb, for which a clinical diagnosis of right renal cancer was made. After laparoscopic radical resection of the right kidney, pathological examination supported the diagnosis of idiopathic retroperitoneal fibrosis. With an unclear pathogenesis, idiopathic retroperitoneal fibrosis presents with atypical clinical manifestations but shows specific features in imaging examination. Its treatment is individualized according to the specific condition for which conservative medical or surgical treatment can be considered. Retroperitoneal fibrosis has a low incidence and a high misdiagnosis rate, and imaging examinations remain currently the primary modality for diagnosis with specific findings.
Diagnostic Errors ; Humans ; Kidney Neoplasms ; Kidney Pelvis ; pathology ; Male ; Middle Aged ; Retroperitoneal Fibrosis ; diagnosis ; Ureter ; pathology