Retroperitoneal Liposarcoma with Choledochal cyst
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Findings
Liver is normal in size. An irregular thin walled hypodense lesion measuring 13 x 6 x 5 cm noted in left lobe communicating with the intrahepatic biliary radicals on left side. No evidence of enhancing solid components/ separations within.
Moderate IHBRD noted with dilatation of common hepatic & common bile ducts. CHD - 2.1 cm, CBD - 2.0 cm. CBD is dilated till the level of Ampulla.
GB is grossly distended with fluid. Circumferential wall thickening noted more so in the fundal region measuring 7 mm. No radio-opaque calculus is seen. No pericholecystic collection.
Large irregular heterogeneously enhancing hypodense mass lesion of fat attenuation value measuring 20 x 16 x 10 cm noted in the pelvis in the pre sacral region. The lesion has a large heterogeneous soft tissue component in its right lateral aspect with focal calcification & multiple thin septae. The lesion is encasing the ureters on both sides.
Superiorly the lesion is extending till L4 vertebral level. The lesion is causing mass effect on the rectum displacing it the left with maintained fat plane. Anteriorly the lesion is causing mass effect on the urinary bladder & prostate, loss of fat plane noted with the right lateral of bladder. Laterally the lesion is displacing the bowel loops.
Prostate is enlarged, measures 50 cc with nodularity & mildly altered attenuation values & enhancement.
Moderate IHBRD noted with dilatation of common hepatic & common bile ducts. CHD - 2.1 cm, CBD - 2.0 cm. CBD is dilated till the level of Ampulla.
GB is grossly distended with fluid. Circumferential wall thickening noted more so in the fundal region measuring 7 mm. No radio-opaque calculus is seen. No pericholecystic collection.
Large irregular heterogeneously enhancing hypodense mass lesion of fat attenuation value measuring 20 x 16 x 10 cm noted in the pelvis in the pre sacral region. The lesion has a large heterogeneous soft tissue component in its right lateral aspect with focal calcification & multiple thin septae. The lesion is encasing the ureters on both sides.
Superiorly the lesion is extending till L4 vertebral level. The lesion is causing mass effect on the rectum displacing it the left with maintained fat plane. Anteriorly the lesion is causing mass effect on the urinary bladder & prostate, loss of fat plane noted with the right lateral of bladder. Laterally the lesion is displacing the bowel loops.
Prostate is enlarged, measures 50 cc with nodularity & mildly altered attenuation values & enhancement.
Diagnosis
• Large irregular heterogenously enhancing hypodense mass lesion of fat attenuation value in the pelvis in the pre sacral region with a large heterogeneous soft tissue component in its right lateral aspect, mass effect & extensions as described - Malignant neoplastic lesion (Likely Liposarcoma).
• Grossly distended Gall bladder with wall thickening as described – Acalculous Cholecystitis.
• An irregular thin walled hypodense lesion in left lobe of Liver with moderate IHBRD communicating with dilated CBD as described - Likely Choledochal cyst (Type IVa).
• Grossly distended Gall bladder with wall thickening as described – Acalculous Cholecystitis.
• An irregular thin walled hypodense lesion in left lobe of Liver with moderate IHBRD communicating with dilated CBD as described - Likely Choledochal cyst (Type IVa).
Dr. Ashraf Nadaf MD is a Consultant Radiologist from with experience of 1-2 year post-graduated from MD. Specialized in Reporting of X-RAYS , CT-SCAN , MRI , MAMMOGRAM cases with expertise in Neuro-imaging , Spine-imaging , Musculoskeletal , Joints , Pediatrics-imaging , Trauma , Stroke-imaging , Dental-imaging
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