Imaging of Primary Malignant Tumors of Peritoneal and Retroperitoneal Origin

  • J. Louis Hinshaw
  • Perry J. Pickhardt
Part of the Cancer Treatment and Research book series (CTAR, volume 143)

Peritoneal carcinomatosis and metastatic involvement of the retroperitoneum are relatively common manifestations of many organ-based malignancies and lymphoproliferative disorders. Primary malignancies of peritoneal and retroperitoneal origin occur much less frequently, and can be difficult to distinguish from metastatic disease. In many cases, a precise diagnosis based on imaging findings alone is not possible. However, the imaging features of these primary tumors, in combination with the clinical and demographic data, can be utilized to narrow the scope of the differential diagnosis. This chapter will present 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 these anatomic spaces.


Germ Cell Tumor Synovial Sarcoma Malignant Mesothelioma Malignant Fibrous Histiocytoma Primary Malignant Tumor 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Pickhardt PJ, Bhalla S. Unusual non-neoplastic peritoneal and subperitoneal conditions: CT findings. Radiographics 2005;25:719–730PubMedCrossRefGoogle Scholar
  2. 2.
    Pickhardt PJ. Peritoneum and retroperitoneum. In: Body CT: a practical approach. Slone RM, Fisher AJ, Pickhardt PJ, Gutierrez, FR, Balfe DM, eds. New York: McGraw-Hill, 2000:159–177Google Scholar
  3. 3.
    Busch JM, Kruskal JB, Wu B. Malignant peritoneal mesothelioma. Radiographics 2002;22:1511–1515PubMedCrossRefGoogle Scholar
  4. 4.
    Pickhardt PJ, Bhalla S. Primary neoplasms of peritoneal and sub-peritoneal origin: CT Findings. Radiographics 2005;25:983–995PubMedCrossRefGoogle Scholar
  5. 5.
    Altaras MM, Aviram R, Cohen I, Cordoba M, Weiss E, Beyth Y. Primary peritoneal papillary serous adenocarcinoma: clinical management and aspects. Gynecol Oncol 1991;40:230–236PubMedCrossRefGoogle Scholar
  6. 6.
    Stafford-Johnson DB, Bree RL, Francis IR, Korobkin M. CT appearance of primary papillary serous carcinoma of the peritoneum. AJR 1998;171:687–689PubMedGoogle Scholar
  7. 7.
    Pickhardt PJ, Fisher AJ, Balfe DM, Dehner LP, Huettner PC. Desmoplastic small round cell tumor of the abdomen: radiologic-histopathologic correlation. Radiology 1999;210:633–638PubMedGoogle Scholar
  8. 8.
    Bodner K, Bodner-Adler B, Mayerhofer S, et al. Malignant fibrous histiocytoma (MFH) of the mesentery: a case report. Anticancer Res 2002;22:1169–1170PubMedGoogle Scholar
  9. 9.
    Yip D, Stacy GS. Malignant Fibrous Histiocytoma, Soft Tissue. Emedicine. Accessed 11/17/06
  10. 10.
    Ros PR, Viamonte M Jr, Rywlin AM. Malignant fibrous histiocytoma: mesenchymal tumor of ubiquitous origin. AJR 1984;142:753–759PubMedGoogle Scholar
  11. 11.
    Rydholm A, Berg NO. Size, site and clinical incidence of lipoma: factors in the differential diagnosis of lipoma and sarcoma. Acta Orthop Scand 1983;54:929–934PubMedGoogle Scholar
  12. 12.
    Myhre-Jensen O. A consecutive seven-year series of 1331 benign soft tissue tumors: clinicopathologic data-comparison with sarcomas. Acta Orthop Scand 1981;52:287–293PubMedGoogle Scholar
  13. 13.
    Kim T, Murakami T, Oi H, et al. CT and MR imaging of abdominal liposarcoma. AJR 1996;166:829–833PubMedGoogle Scholar
  14. 14.
    Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 2002;224:99–112PubMedCrossRefGoogle Scholar
  15. 15.
    Kim HC, Lee JM, Kim SH, et al. Primary gastrointestinal stromal tumors in the omentum and mesentery: CT findings and pathologic correlations. AJR 2002;182:1463–1467Google Scholar
  16. 16.
    Meis JM, Enzinger FM. Inflammatory fibrosarcoma of the mesentery and retroperitoneum: a tumor closely simulating inflammatory pseudotumor. Am J Surg Pathol 1991;15:1146–1156PubMedGoogle Scholar
  17. 17.
    Ko SF, Chou FF, Huang CH, et al. Primary synovial sarcoma of the gastrocolic ligament. Br J Radiol 1998;71:438–440PubMedGoogle Scholar
  18. 18.
    Granstrom P, Unger E. MR imaging of the retroperitoneum. Magn Reson Imaging Clin N Am 1995;3:121–142PubMedGoogle Scholar
  19. 19.
    Engelken JD, Ros PR. Retroperitoneal MR Imaging. Magn Reson Imaging Clin N Am 1997;5:165–178PubMedGoogle Scholar
  20. 20.
    Clary BM, DeMatteo RP, Lewis JJ, Leung D, Brennan MF. Gastrointestinal stromal tumors and leiomyosarcomas of the abdomen and retroperitoneum: a clinical comparison. Ann Surg 2001;8:290–299CrossRefGoogle Scholar
  21. 21.
    Hartman DS, Hayes WS, Choyke PL, Tibbetts GP. Leiomyosarcoma of the retroperitoneum and inferior vena cava: radiologic-pathologic correlation. Radiographics 1992;12:1203–1220PubMedGoogle Scholar
  22. 22.
    Sondak V, Economou J, Eilber F. Soft tissue sarcomas of the extremity and retroperitoneum: advances in management. Adv Surg 1991;24P:333–359Google Scholar
  23. 23.
    Erlandson R, Klimstra D, Woodruff J. Sub-classification of gastrointestinal stromal tumors based on evaluation by electron microscopy and immunohistochemistry. Ultrastruct Pathol 1996;20:373–393PubMedCrossRefGoogle Scholar
  24. 24.
    Matsuki K, Kakitsubata Y, Watanabe K, Tsukino H, Nakajima K. Mesenteric plexiform neurofibroma associated with Recklinghausen’s disease. Pediatr Radiol 1997;27:255–256PubMedCrossRefGoogle Scholar
  25. 25.
    Melicow MM. One hundred cases of pheochromocytoma (107 tumors) at the Columbia-Presbyterian Medical Center, 1926–1976: a clinicopathological analysis. Cancer 1977;40:1987–2004PubMedCrossRefGoogle Scholar
  26. 26.
    Glenn F, Gray GF. Functional tumors of the organ of Zuckerkandl. Ann Surg 1976;183:578–586PubMedGoogle Scholar
  27. 27.
    Hayes WS, Davidson AJ, Grimley PM, Hartman DS. Extraadrenal retroperitoneal paraganglioma: clinical, pathologic, and CT findings. AJR 1990;155:1247–1250PubMedGoogle Scholar
  28. 28.
    Makhoul I, Curti B. Extragonadal germ cell tumors. Emedicine. Accessed 11/14/06
  29. 29.
    Nichols CR, Fox EP. Extragonadal and pediatric germ cell tumors. Hematol Oncol Clin North Am 1991;5:1189–1209PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • J. Louis Hinshaw
    • 1
  • Perry J. Pickhardt
    • 1
  1. 1.Department of RadiologyUniversity of Wisconsin Medical SchoolMadisonUSA

Personalised recommendations