PMC4900119_01
46-year-old male with a left retroperitoneal mass. Portovenous-phase, contrast-enhanced coronal image demonstrates extensive flocculent calcification and mass effect on the left kidney. Multiple enhancing thick septations (arrowhead), nodules (arrows), and fat-density lobules (*) are scattered along the periphery of the lesion.
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fig1A
A CT scan of the abdomen and pelvis demonstrated a large, heterogeneously enhancing retroperitoneal mass measuring 8.4 x 16.5 x 18.4 cm (Fig. 1A). The anterior and posterior renal fascias were poorly delineated, with multiple small, enhancing satellite nodules extending into the adjacent pararenal space (Fig. 1B). There were extensive areas of curvilinear and flocculent mineralization along the periphery of the main lesion, with central areas of low attenuation suggestive of necrosis (Fig. 1C). Of note were multiple discrete foci with fat attenuation that were scattered peripherally along the lateral and inferior margins of the mass (Fig 1D).
46-year-old male with a left retroperitoneal mass. Portovenous-phase, contrast-enhanced axial image demonstrates extensive flocculent calcification with multiple enhancing thick septations (arrowhead). A dominant heterogeneously enhancing nodule (arrow) abuts the left psoas muscle. The left kidney is displaced anteriorly and cephalad. A central island of fat-density tissue (*) is wedged between the left kidney and the enhancing satellite nodule.
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fig1B
On gross pathologic review, the specimen measured 22 cm in greatest dimension; cut sections revealed a large cystic cavity containing hemorrhagic fluid (Fig. 2).
46-year-old male with a left retroperitoneal mass. Portovenous-phase, contrast-enhanced axial image demonstrates extensive flocculent calcification and mass effect on the left kidney. Enhancing thick septations (arrowhead) and a satellite nodule (arrows) are present along the periphery of the lesion.
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fig1C
Microscopic examination of the tumor displayed only small residual foci of well-differentiated liposarcoma, with a predominance of dedifferentiation including foci of osteoid formation (Figure 3, Figure 4).
46-year-old male with a left retroperitoneal mass. ROI measurement of a central fat-attenuation lobule.
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fig1D
Microscopic examination of the tumor displayed only small residual foci of well-differentiated liposarcoma, with a predominance of dedifferentiation including foci of osteoid formation (Figure 3, Figure 4).