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Japanese Journal of Clinical Oncology 2008 38(7):507; doi:10.1093/jjco/hyn051
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© The Author (2008). Published by Oxford University Press. All rights reserved

A Case of Diffuse Retroperitoneal Lymphangioma with Endometrial Cancer

Michihiro Tanikawa and Takahiro Kasamatsu

Gynecology Division
National Cancer Center Hospital
Tokyo, Japan

A 46-year-old female patient was referred to our hospital for further evaluation and treatment of endometrial cancer. The curettage specimen revealed moderately-differentiated endometrioid adenocarcinoma of the uterine corpus. Computed tomography and magnetic resonance imaging showed the diffuse proliferation of soft tissue in the retroperitoneal area, spreading from the level of common iliac vessels up to renovascular level (Fig. 1), and extending along the inferior mesenteric artery (Fig. 2, white arrow head). The present neoplasm was not typical for the lymph node metastasis of endometrial cancer, and it raised the possibility of malignant lymphoma. We conducted surgical treatment for both endometrial cancer and exploration of retroperitoneal neoplasm.


Figure 1
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  		Figure 1.
 

Figure 2
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She underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and biopsy of the retroperitoneal neoplasm. The endometrial cancer had superficial myometrial invasion macroscopically in the resected uterus, but in the retroperitoneal space the yellowish soft tissue adhered to the abdominal aorta, the inferior vena cava and the common iliac vessels. It also extended into the mesentery of the sigmoid colon. However, frozen section of the soft tissue revealed no malignancy, so she did not undergo resection of the retroperitoneal neoplasm.

The final pathological diagnosis was lymphangioma (Fig. 3). Lymphangioma is a rare benign neoplasm of the lymphatic system, and retroperitoneal lymphangioma accounts for 1% of all lymphangiomas. Although the retroperitoneal lymphangioma is a benign neoplasm, it may cause significant morbidity because of its invasive character and size. The patient has to be followed up carefully not only for endometrial cancer but also for retroperitoneal lymphangioma.


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  		Figure 3.
 


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This Article
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