Primary malignant tumors of peritoneal and retroperitoneal origin: clinical and imaging features

Our plain-English summary of Primary malignant tumors of peritoneal and retroperitoneal origin: clinical and imaging features, by M.G. Lubner, J.L. Hinshaw, P.J. Pickhardt (Surgical Oncology Clinics of North America, 2014).

The study

• Authors: M.G. Lubner, J.L. Hinshaw, P.J. Pickhardt
• Journal: Surgical Oncology Clinics of North America
• Published: 2014;23(4):821-45
• Type of article: Review
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Peritoneal carcinomatosis and metastatic involvement of the retroperitoneum are manifestations of many organ-based malignancies and lymphoproliferative disorders. Primary malignancies of peritoneal and retroperitoneal origin occur much less frequently, and are difficult to distinguish from metastatic disease on imaging alone. However, the imaging features of these primary tumors, taken in concert with the clinical data, can be helpful in narrowing the scope of the differential diagnosis. This review presents the clinical and imaging features of primary peritoneal and retroperitoneal tumors arising from the various tissue components that comprise the ligaments, mesenteries, and connective tissues of the peritoneal and retroperitoneal spaces.

Copyright © 2014 Elsevier Inc. All rights reserved.

In plain English

This article was a narrative review, not a study of patients or of asbestos exposure. It described how rare cancers that start in the abdominal lining (peritoneum) or the space behind it (retroperitoneum) present clinically and appear on scans such as CT, illustrated with images from individual patients. Drawing on earlier published work, its mesothelioma section stated that about 30% of mesotheliomas arise solely from the peritoneum, that peritoneal mesothelioma is less often associated with asbestos exposure than the pleural form, and that cases involving both pleura and peritoneum are usually asbestos-related. It gave median survival for untreated peritoneal mesothelioma as 5 to 12 months. It noted that calcification is uncommon in peritoneal mesothelioma, whereas papillary serous carcinoma, called the most common primary peritoneal tumor, is often densely calcified. Liposarcoma was named the most common primary retroperitoneal tumor, followed by leiomyosarcoma. The authors concluded that these rare tumors should be considered when no organ-based cancer is known, and that imaging helps with detection, staging, guiding biopsy and assessing treatment response.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of the clinical and imaging features of primary peritoneal and retroperitoneal malignancies, illustrated with imaging cases
• Who was studied: No study population. The review covered published literature (52 references) on primary malignancies of the peritoneal, subperitoneal and retroperitoneal spaces, with illustrative CT, ultrasonography and MR images from individual patients (for example, a 63-year-old man with dry peritoneal mesothelioma).
• Exposure: No exposure was studied. Asbestos is mentioned only in the mesothelioma section, citing earlier work; no fiber types are named.
• Main results:
  • Citing earlier work, the review stated that mesothelioma most frequently involves the pleural space, but approximately 30% arise solely from the peritoneum.
  • Citing earlier work, the review stated that, compared with the pleural form, malignant mesothelioma of the peritoneum is less often associated with asbestos exposure, but cases with both pleural and peritoneal involvement are usually asbestos-related.
  • Citing earlier work, the review stated that for untreated cases of malignant peritoneal mesothelioma, median survival ranges from 5 to 12 months, with little improvement in patients receiving multimodality therapy.
  • Imaging features of peritoneal mesothelioma were described as variable, with a 'dry' appearance (soft-tissue masses) and a 'wet' appearance (peritoneal thickening with ascites).
  • Calcification, either within the mass or associated with peritoneal plaques, was described as uncommon in peritoneal mesothelioma; the authors advised considering other causes when a peritoneal-based tumor is extensively calcified.
  • Papillary serous carcinoma was described as the most common primary tumor of the peritoneum, occurring almost exclusively in women and often densely calcified.
  • Liposarcoma was described as the most common primary tumor of the retroperitoneum, followed by leiomyosarcoma.
  • Imaging was described as useful in detection, staging, guiding biopsy and evaluating response to therapy.
• The authors' conclusion: The authors concluded that primary peritoneal and retroperitoneal malignancies are much less frequent than metastatic disease but should be considered when there is no known or suspected organ-based malignancy, and that cross-sectional imaging can be useful even though a specific diagnosis from imaging alone can be difficult.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Retroperitoneum, Differential Diagnosis.

Related studies

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• Nuclear Brachyury Expression Is Consistent in Chordoma, Common in Germ Cell Tumors and Small Cell Carcinomas, and Rare in Other Carcinomas and Sarcomas: An Immunohistochemical Study of 5229 Cases — M. Miettinen, Z. Wang, et al. (2015)
• Malignant peritoneal mesothelioma with lower extremity metastasis: PET/CT imaging — B.B. Le, B.D. Nguyen (2015)
• Imaging features, complications and differential diagnoses of abdominal cystic lymphangiomas — M. Raufaste Tistet, O. Ernst, et al. (2020)
• Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases — U. Raju, G. Fine, et al. (1989)

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