A Huge Retroperitoneal Large B-Cell Lymphoma Presenting as Chronic Small Bowel Obstruction: A Case Report

Abstract

Retroperitoneal tumours are an aggregate of multiple types of neoplastic lesions with a preponderance of tumours of mesenchymal origin. Other histological types such as Lymphoma, are reported to be commoner now. Retroperitoneal tumours are generally rare and clinical diagnosis is often difficult due its cryptic location. It is often diagnosed incidentally following abdominal radiological studies or following complications. The most common complication being an extrinsic compression, particularly, on the retroperitoneal structures; such as the ureters, duodenum or the major abdominal vessels. It may also present as a vague abdominal pain or chronic bowel obstruction like our index patient. Abdominal CT Scan is the most sensitive tool of diagnosis and complete surgical excision often, an enbloc excision with involved adjoining organs offers the best chance of cure. Adjuvant chemotherapy, radiotherapy or chemo-radiation improve disease free interval and overall survival. The mainstay of retroperitoneal lymphoma is however a cytotoxic chemotherapy or more recently Rituximab combination therapy. We present a case of a huge retroperitoneal large B-cell Lymphoma presenting as chronic small bowel obstruction.