Ultrasound is successful in identifying retroperitoneal masses, but CT and MRI are more effective
at establishing the extent and nature of many of these masses, particularly those partly obscured by
gas-filled bowel.
The majority of malignant retroperitoneal tumours are renal or adrenal in origin. Other primary
tumours, apart from lymphomas, are rare, and include liposarcoma and leiomyosarcoma.
These tend to be large when they present, and of variable/complex ultrasound appearance. Encasement
of major vessels by tumour is a further characteristic of the retroperitoneal origin of the mass,
together with anterior displacement of structures such as the pancreas, kidneys, aorta and IVC.
Ultrasound is also able to identify peritoneal and omental deposits in patients with late-stage carcinoma.
These are particularly amenable to diagnosis when surrounded by ascites (Fig.ultrasound images below) and
usually arise from gynaecological or urological tumours.
ultrasound images of Late-stage breast carcinoma demonstrates abdominal ascites with a hyperechoic
omental cake of metastatic deposit in the left upper quadrant (LUQ).
ultrasound images of A large, irregular omental deposit from ovarian carcinoma was palpable during the scan.
ultrasound images of Retroperitoneal metastases from a teratoma.Benign retroperitoneal masses identifiable on ultrasound include haematomas, psoas abscesses, lymphadenopathy (Fig. ultrasound images below) and pancreatic pseudocysts.
Ultrasound images of Enlarged lymph node anterior to the aorta (arrow).
Ultrasound images Lymphadenopathy may be the cause of obstructive jaundice.
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