College of American Pathologists

2013 — January Case of the Month

Posted January 8, 2013

CLINICAL SUMMARY: Retroperitoneum  

CAP Foundation Online Case of the Month

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A 44-year-old woman presented with abdominal pain and was discovered to have a retroperitoneal/pelvic mass which was resected, along with several lymph nodes. The retroperitoneal mass measured 8.0 x 3.5 x 3.0 cm and had a hemorrhagic cut surface. The lymph nodes were enlarged and the cut surface had a similar appearance to the pelvic mass. A hysterectomy and bilateral salpingo-oophorectomy was performed at the same time which was essentially unremarkable except for adenomyosis. Immunohistochemical stains performed on the retroperitoneal mass demonstrated actin (+), HMB-45 (+) and ER (+).

The master list with the correct answer

  • Kaposi sarcoma
  • Leiomyosarcoma
  • Lymphangioleiomyomatosis
  • Peritoneal leiomyomatosis
  • Vascular transformation of sinuses (lymph node)

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  • Appropriate diagnosis
  • Critique
  • References

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