• Tahir Abdullah Hawrami College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Dalya Tariq Aziz General Surgery Board Trainee, Sulaimani Teaching Hospital, Kurdistan Region, Iraq.
  • Dara Ahmed Mohammed College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.




Retroperitoneal masses, Tumours, Laparotomy, Neoadjuvant, Liposarcoma



Retroperitoneal masses are a large group of uncommon tumours which originate in the retroperitoneal space in the abdomen. Their diverse presentations and locations make them difficult to diagnose by surgeons and need precise radiological diagnosis. Most of the diagnosed tumours are in advanced size and stage and are malignant in nature. Some of them are radio/chemotherapy sensitive but the definite management should be by complete resections of the tumours.


The primary aim of our study is to identify patients diagnosed with retroperitoneal masses among elective cases in two surgical hospitals in Sulaimani governorate/ Iraq over four years. All underwent combined surgical management with chemo/radiotherapy and followed up.

Materials and Methods

Seven patients with retroperitoneal masses are reported in this paper, five of whom are male and two females. Their ages range from 3 to 72 years, and the mean age is 40.4. In addition, other surgeons who practiced in different specialties brought some of the cases to us. Over four years, they were hospitalized and treated at Sulaimani Teaching Hospital and Soma Private Hospital. The patients underwent surgery following a thorough history, physical examination, and imaging, and the histological findings determined the definitive diagnosis. In addition to direct questioning the patients and patients’ parents (as one case was a child) to obtain their consent, information was gathered from the medical records of both hospitals.


Complete resection of retroperitoneal tumours by surgical approach was reported in five patients included in the study, and residual tumours were reported in two. An uneventful post-operative period in all of them, and recurrence was recorded in the follow-up period in three of them. Histopathological findings were: two well-differentiated liposarcomas, one dedifferentiated liposarcoma, one Ewing sarcoma, one rhabdomyosarcoma, one ganglioneuroma, and one lipoma. Mortality was reported in three of the patients. 


Retroperitoneal tumours are rare and require precise diagnosis by physical examination and imaging modalities. The primary management method in our study was surgical resection combined with neoadjuvant chemo/radiotherapy and regular follow-up.


Mota MMDS, Bezerra ROF, Garcia MRT. A practical approach to primary retroperitoneal masses in adults. Vol. 51, Radiologia Brasileira. Colegio Brasileiro de Radiologia; 2018. p. 391–400. DOI: https://doi.org/10.1590/0100-3984.2017.0179

Carbone F, Pizzolorusso A, Di Lorenzo G, Di Marzo M, Cannella L, Barretta ML, et al. Multidisciplinary management of retroperitoneal sarcoma: Diagnosis, prognostic factors and treatment. Cancers (Basel). 2021;13(16):1–15. DOI: https://doi.org/10.3390/cancers13164016

Sassa N. Retroperitoneal tumours: Review of diagnosis and management. Int J Urol. 2020;27(12):1058–70. DOI: https://doi.org/10.1111/iju.14361

Das S, Das A, Mandal PR. A Short-Term Prospective Study of Retroperitoneal Tumours in a Tertiary Hospital in Eastern India. J Evol Med Dent Sci. 2020;9(07):448–52. DOI: https://doi.org/10.14260/jemds/2020/101

Gemici K, Buldu ibrahim, Acar T, Alptekin H, Kaynar M, Tekinarslan E, et al. Management of patients with retroperitoneal tumours and a review of the literature. World J Surg Oncol. 2015;13(1):1–8. DOI: https://doi.org/10.1186/s12957-015-0548-z

Brennan C, Kajal D, Khalili K, Ghai S. Solid malignant retroperitoneal masses-a pictorial review. Insights Imaging. 2014;5(1):53–65. DOI: https://doi.org/10.1007/s13244-013-0294-0

Strauss DC, Hayes AJ, Thomas JM. Retroperitoneal tumours: Review of management. Ann R Coll Surg Engl. 2011;93(4):275–80. DOI: https://doi.org/10.1308/003588411X571944

Basavaraju UK, Rajendrakumar NL, Sanjay P, Puttaraj NC, PShivadas P, Seetharam M, et al. Diagnosis of Retroperitoneal Tumours using Computed Tomography- A Cross-sectional Study. Int J Anat Radiol Surg. 2021;10(1):32–7. DOI: https://doi.org/10.7860/IJARS/2021/44895.2598

Tapadia J, Gajakos AS. Study the incidence of various retroperitoneal masses and the accuracy of MDCT in detecting retroperitoneal masses. 2021;4(12):154–9.

Acar T, Harman M, Guneyli S, Gemici K, Efe D, Guler I, et al. Cross-sectional Imaging Features of Primary Retroperitoneal Tumors and Their Subsequent Treatment. J Clin Imaging Sci. 2015;5(1). DOI: https://doi.org/10.4103/2156-7514.156135

Lee F, Huang T-S, Ng X-Y, Ko W-C, Liu C-L, Lin J-C. Surgical management of primary retroperitoneal tumours – Analysis of a single centre experience. J Cancer Res Pract [Internet]. 2017;4(2):49–52. Available from: http://dx.doi.org/10.1016/j.jcrpr.2017.01.001 DOI: https://doi.org/10.1016/j.jcrpr.2017.01.001

Rajiah P, Sinha R, Cuevas C, Dubinsky TJ, Bush WH, Kolokythas O. Imaging of uncommon retroperitoneal masses. Radiographics. 2011;31(4):949–76. DOI: https://doi.org/10.1148/rg.314095132

Tseng WW, Wang SC, Eichler CM, Warren RS, Nakakura EK. Complete and safe resection of challenging retroperitoneal tumours: Anticipation of multi-organ and major vascular resection and use of adjunct procedures. World J Surg Oncol. 2011;9:2–7. DOI: https://doi.org/10.1186/1477-7819-9-143

Skapek SX, Ferrari A, Gupta A, Lupo PJ, Butler E, Shipley J, et al. Rhabdomyosarcoma HHS Public Access. Nat Rev Dis Prim. 5(1):1. DOI: https://doi.org/10.1038/s41572-018-0051-2

Papaetis GS, Georgiadis CP, Tsitskari MA, Constantinou PG, Antoniou AP. Retroperitoneal ganglioneuroma causing chronic lower back and leg pain in an 80-year-old man: A case report. Ann Med Surg [Internet]. 2021;61(November 2020):101–3. Available from: https://doi.org/10.1016/j.amsu.2020.12.027 DOI: https://doi.org/10.1016/j.amsu.2020.12.027



How to Cite

Hawrami T, Aziz D, Mohammed D. A CASE STUDY ON RETROPERITONEAL MASSES. JSMC [Internet]. 2023 Mar. 21 [cited 2024 Jun. 24];13(1):89-98. Available from: https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10401

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)