2025年 · 第40卷第06期

The patient was a 53-year-old female. Admitted to hospital on June 19, 2023 for "accidental discovery of abdominal mass on ultrasound". Physical examination revealed the presence of a hard, non-tender mass in the right abdomen, approximately 24 cm ×16 cm in size. CT scan revealed a huge cystic-solid mass in the abdominal cavity that compressed the right kidney and was unclear from the right kidney (Figure 1). Retroperitoneal tumor resection was performed and the tumor was finely dissected and resected while preserving the surrounding kidney tissue intact. The size of postoperative pathological specimens was approximately 23 cm ×17 cm (Fig. 2A), and the tumor was composed of mature adipose tissue, thick-walled blood vessels, and smooth muscle in different proportions (Fig. 2B). Immunohistochemical examination showed positive staining for Melan-A (FIG. 3), HBM 45, S-100, and weakly positive staining for CD34. The final diagnosis was renal angiomyolipomas (RAML) according to the pathological findings. No tumor recurrence and metastasis were observed as of the latest follow-up on 20 Aug 2024.

A 58-year-old female patient found "abdominal mass for 1 week" on physical examination. On June 23, 2021, "Retroperitoneal lesion resection + appendectomy + barrier placement" was performed in our hospital. During the operation, it was found that the tumor originated from the retroperitoneum and adhered closely to the adjacent mesenteric, duodenal, pancreatic and inferior mesenteric veins. The size of the tumor was about 10 cm ×10 cm ×8 cm, and there were no enlarged lymph nodes adjacent to the abdominal aorta. Postoperative pathological examination：Generally, a nodular mass was seen, with a size of 15 cm ×11 cm ×9 cm, with a smooth surface, gray-powder and gray-yellow cut surface, soft and slightly brittle texture. Observation under the microscope: The tumor cells are abundant, arranged in a solid nest shape, the interstitium contains abundant small blood vessels, the cells far from the blood vessels degenerate, and the cells around the blood vessels are arranged in a pseudopapillary shape (Figure 1). The tumor cytoplasm is medium and eosinophilic, the nucleus is the same size, the nuclear groove is common, and the eosinophilic transparent droplets are occasionally seen in the cytoplasm (Figure 2). Immunohistochemical results: CKpan (-), Vimentin (+), Syn (+) (Fig. 3), β-catenin (nucleus +) (Fig. 4), CD56 (+), CgA (-), CD10 (+), Calretnin (-), MC (-), CD117 (-), Dog (-), Ki67 (number of positive cells ~5%), S100 (partial +), CD34 (-), WT1 (-), CD30 (-), SALL4 (-), CD30 (-), AFP (-), CD99 (-). Pathological diagnosis: (Retroperitoneal mass) solid-pseudopapillary tumor with necrosis.