The diagnosis of retroperitoneal tumors from a radiologist perspective: a case report of a giant intramuscular hemangioma in a 23-year old patient

Primary retroperitoneal tumors are a heterogeneous group of neoplasms with a prevalence of 0.02 to 1%. The results of diagnostic visualization of such tumors are usually ambiguous due to their diversity and similar radiological semiotics of malignant and benign tumor types. The paper describes a rare case of the diagnosis and management of a patient with one of retroperitoneal tumor, i. e. a giant intramuscular hemangioma. A 23-year old male patient was referred with complaints of episodic pains in the right inguinal area for 78 years. The multiaxial computed tomography showed a mass of 145 125 125 mm located in the trunk and pelvis, and spreading to the right thigh. The tumor structure was markedly heterogeneous and contained calcinates, adipose tissue, soft tissue and vascular components. The mass showed a heterogeneous contrast accumulation, with predominant delayed-phase enhancement. The tumor was surgically resected, with the histological investigation characteristic of intramuscular hemangioma. Rare retroperitoneal tumors are always challenging in the interpretation of the results of diagnostic visualization. Since their various types have similar radiological semiotics, the differential diagnosis is often impossible. Therefore, the main diagnostic issue should be the exact localization of the neoplasm, identification of the feeding vessels, and the assessment of the adjacent tissue abnormalities.