case_images: PMC10673338_01
case_images: Coronal image (a) and axial images (b, c) showed a large multilocular cystic tumor which extended under the diaphragm into the pelvis and surrounded the left kidney and spleen. The right lung mass (d) and the soft tissue structures in the retroperitoneal cystic tumor (e) were strongly enhanced by FDG-PET. CT-guided percutaneous biopsy-targeted left perirenal soft tissue structure was underwent in prone position (f).
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case_images: F1
case_images: Contrast computed tomography (CT) uncovered a large multilocular cystic retroperitoneal tumor that extended under the diaphragm to the lower pole of the left kidney and surrounded the stomach, spleen, pancreas, left kidney, and abdominal aorta (Fig. 1a-c). The liver was widely bordered, and poorly marginated soft tissue structures were present around the abdominal aorta, inferior vena cava, pancreas, mesentery, and left kidney (Fig. 1b, c). CT also revealed a right lung mass (Fig. 1a). The soft tissue structures in the retroperitoneal cystic tumor and right lung mass were strongly enhanced on 2-deoxy-2-[fluorine-18] fluoro-d-glucose positron emission tomography, suggesting a malignant retroperitoneal tumor and lung metastasis (Fig. 1d, e). CT performed 1.5 months after the previous examination illustrated that the soft tissue structures were generally progressing. CT-guided percutaneous biopsy targeting the left perirenal soft tissue structure, which was surrounded by cystic masses, was conducted (Fig. 1f).
case_images: Histopathology revealed the proliferation of spindle- to polygonal-shaped tumor cells with enlarged hyperchromatic nuclei arranged in a haphazard pattern (a). Immunohistochemically, the tumor cells were positive for MDM2 (b) and CDK4 (c).
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case_images: F2
case_images: Histopathological finding revealed the proliferation of spindle- to polygonal-shaped tumor cells with enlarged hyperchromatic nuclei arranged in a haphazard pattern (Fig. 2a). Immunohistochemically, the tumor cells were positive for MDM2 (Fig. 2b) and CDK4 (Fig. 2c).