[Skip to Content]
[Skip to Content Landing]
Views 237
Citations 0
JAMA Surgery Clinical Challenge
September 2017

An Incidental Hypervascular Retroperitoneal Mass

Author Affiliations
  • 1Vanderbilt University School of Medicine, Nashville, Tennessee
  • 2Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
  • 3Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee
JAMA Surg. 2017;152(9):887-888. doi:10.1001/jamasurg.2017.2147

A 69-year-old white man presented to the emergency department after a tractor-on-tree collision. Contrast-enhanced computed tomography demonstrated an incidental right infrarenal, retroperitoneal mass measuring 9.7 × 7.7 × 9.1 cm (Figure 1A), with dilated tortuous supply from a lumbar artery branch and retroperitoneal lymphadenopathy. He denied any history of systemic symptoms, pain, urinary symptoms, or abnormal bowel function but described 6 years of decreased appetite. Laboratory evaluation of plasma-free metanephrine levels showed a slight elevation in normetanephrine levels (1.21 nmol/L). Given the dramatic arterial enhancement and hypertrophied perivascular plexus, biopsy was not performed, and preoperative arterial embolization was deemed appropriate to minimize intraoperative blood loss.

First Page Preview View Large
First page PDF preview
First page PDF preview
×