Retroperitoneal Cavernous Hemangioma Detected on Physical Examination

Abstract

A 52-year-old woman consulted a physician at the Department of Cardiology in our hospital because she had hypertension of over 180 mmHg. To rule out primary aldosteronism, abdominal computed tomography (CT) was performed, revealing a 30 × 40 mm tumor with calcification, surrounded by the duodenum and right kidney. Enhanced CT displayed pale tumor staining at the equilibrium phase. Fluorodeoxyglucose-positron emission tomography (FDG-PET) /CT showed accumulation of SUVmax 3.5 in the same area, and magnetic resonance imaging (MRI) showed a homogeneous tumor with low T1W1 and markedly high T2W1 signals. Overall, this tumor was diagnosed as either a neurogenic tumor, a liposarcoma, or a hemangiosarcoma. Finally, we decided on tumor resection to make a definitive diagnosis without a preoperative needle biopsy. The operation was initiated via an anterior approach through the abdominal cavity. The resected tumor was diagnosed as a cavernous hemangioma. Retroperitoneal cavernous hemangiomas are quite rare. Perioperative diagnosis is usually difficult because the findings from images, including enhanced CT and MRI, display great diversity, such as hypo- or hypervascular staining. In conclusion, we should consider cavernous hemangioma as a differential diagnosis in retroperitoneal tumors.