Differential diagnosis of pelvic tumors in females: two MRI cases of rare extragenital pelvic lesions.

Berezovskaya T.P., Proshin A.A., Mozerov S.A., Shavladze Z.N., Kostyuk I.P., Galkin V.N.

Purpose. To present two cases of rare extragenital pelvic lesions in female patients demonstrating the possibility of MRI in differential diagnosis of pelvic tumors and illustrating the algorithm of MRI analysis in revealing retroperitoneal pelvical tumors. Materials and methods. In the clinic of A. Tsyb Medical Radiological Research Cen-ter two female patients (26 and 53 y.o.) with suspected pelvic tumors were examined and treated. Both patients underwent MRI of the pelvis for clarifying the localization, origin and character of the lesions and planning of the further treatment. Results. In both cases, MRI revealed retroperitoneal lesions in the pelvic region. In the 26-year-old patient, the heterogeneous solid mass originated from the region of the in-ternal obturator muscle, had a heterogeneous structure with an intermediate signal intensity on T2-WI compressing and displacing the rectum and vagina to the contralateral pelvic wall without any signs of lymphogenous metastases. The patient was surgically treated; pathomorphological analysis of the specimen revealed an intraabdominal desmoid fibroma-tosis. In the second patient, MRI revealed a cystic lesion localized in the retroctectal-presacral space, with a solid component in the lower pole extending into the ischiorectal fos-sa with signs of infiltrative growth and metastastatic process in the unilateral pelvic bone. Surgical treatment was performed. In the solid component of the lesion, extraovarian mu-cinous cystadenocarcinoma G1 was diagnosed pathomorphologically. The final diagnosis was “mucinous cystadenocarcinoma, developed in a retrorectal cystic hamartoma with metastasis to the hip bone”. Conclusion. Both cases confirm the key role of MRI in the diagnosis of retroperitoneal pelvic lesions, in identifying the signs of malignancy, assessing the spread of the pathological process and treatment planning, although the final diagnosis requires a pathomorphological confirmation.

1 - A. Tsyb Medical Radi-ological Research Center, branch of the National Medical Research Radio-logical Center. 2 - “Medical and Diag-nostic Center. ST-Dent”.

 

 

 

 

 

Keywords:MRI, pelvic tumors, retroperitoneal tumors, intraabdominal desmoid fibromatosis, malignant retrorectal cystic hamartoma.

 

Corresponding author:Proshin A.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Berezovskaya T.P., Proshin A.A., Mozerov S.A., Shavladze Z.N., Kostyuk I.P., Galkin V.N. Differential diagnosis of pelvic tumors in females: two MRI cases of rare extragenital pelvic lesions. REJR. 2017; 7 (3):188-198. DOI:10.21569/2222-7415-2017-7-3-188-198.

Received: 22.04.2017 Accepted:28.08.2017