Presentation
Epigastric discomfort.
Patient Data
A retroperitoneal homogeneous solid mass lesion is seen at the epigastric region in right paramidline location. Superiorly, it extends to porta hepatis inbetween the portal vein and inferior vena cava. Posteriorly, it gently compresses the left renal vein and IVC. Anteriorly, it displaces the portal vein, superior mesenteric vein and pancreas anteriorly.
Right hepatic artery originates from superior mesenteric artery which constitutes the main arterial supply of the lesion.
No locoregional lymph nodes identified.
The tumor is mildly increased in size.
Endoscopic ultrasound was done after the first scan, through which a FNB was taken.
Histopathological findings revealed Leiomyoma.
Case Discussion
Retroperitoneal leiomyomas are very rare. They are histologically similar to uterine leiomyoma in females. Only few case reports are available in literature for such entity 1,2. Surgery is usually curative.
In this case, surgery was attempted before endoscopic ultrasound-guided biopsy and it was difficult to dissect around the lesion and the surgical biopsy was unrepresentative of the mass as well.
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