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Chronic or nonhealing wounds is a complex disease influenced by a multitude of factors, such as infection, ischemia, malnutrition, and diabetes and infrequently relates to retroperitoneal carcinoma. We present a case of an adenocarcinoma of ascending colon in a 68-year-old male who had lumbago and waist fistulas with retroperitoneal abscesses preceding other signs or symptoms of colonic malignancy. Supplemental information regarding the diagnosis and treatment of nonhealing wounds and colon carcinoma has also been included in the report. Adenocarcinoma of ascending colon is rarely associated with nonhealing wounds; nevertheless, it should be considered in cases with long-term healing complications. Precise diagnostic deliberation is crucial in the management and treatment of all chronic and long-term nonhealing lesions, and appropriately performed biopsies are essential to determine whether malignancy is the primary cause.

Local recurrence after radical nephroureterectomy (RNU) owing to urothelial carcinoma of the upper urinary tract is rare. The usual treatment is systemic chemotherapy followed by optional resection of the mass. We introduce the case of a 73-year-old male patient with multiple comorbidities in whom retroperitoneal carcinoma recurrence of 31 mm was diagnosed via positron emission tomography-computed tomography scan with 18-fluorodeoxyglucose about 5 years after he had undergone RNU owing to urothelial carcinoma of the upper urinary tract. The patient was treated with computed tomography-guided percutaneous radiofrequency ablation. Later scans with contrast controls showed lack of contrast uptake and a decrease of the lesion's size. Twenty-four months after the procedure, the patient is free of the disease. To date, this is the first case of recurrence of urothelial carcinoma that was treated with percutaneous radiofrequency ablation, thus establishing an alternative to chemotherapy in patients with substantial comorbidities.

To describe six cases of unknown primary carcinoma of the retroperitoneum that were positive for human papillomavirus (HPV), a surrogate molecular marker for high-risk HPV (p16), or both.Using the MD Anderson pathology database, females with confirmed HPV or p16 expression within retroperitoneal carcinomas of unknown primary were identified. Clinical data were collected by retrospective chart review. One pathologist reviewed all histology. Individuals with known primary were excluded. Data regarding individual demographics, presentation, Pap test history, pathology, HPV and p16 positivity, and outcome were analyzed using descriptive statistics.Six individuals were identified. The median age of the individuals was 43.5 years (range 27-54). Three malignancies (50%) were squamous and three (50%) were undifferentiated. Median follow-up was 12 months (range 6-48 months). Two of the six (33%) individuals had remote histories (more than 10 years) of abnormal Pap test results. All had normal gynecologic examination and Pap test results at diagnosis. Four tumors were HPV-positive (66%) and six were p16-positive (100%). All samples that were HPV-positive were also p16-positive. All individuals underwent treatment with chemotherapy, radiation, or both. One individual underwent initial attempt at resection that was unsuccessful. Two individuals are without evidence of disease, two have had progression of disease, and two have died of their disease.Pelvic masses of unknown primary may be HPV-related despite normal cervical examinations.III.

A 7-year-old, intact, anestrous, female Doberman pinscher was presented with anorexia and hindlimb swelling of three days duration. Renal failure was documented. Survey radiographs revealed patchy alveolar consolidation and bilateral renomegaly with increased retroperitoneal and sublumbar soft tissue opacification. Renal ultrasonography showed bilateral hydronephrosis with ectatic ureters. A retroperitoneal carcinoma was identified via fine needle aspiration. Percutaneous nephropyelocentesis and antegrade nephrography further delineated the hydronephrosis and ureteral obstruction.

Patients with carcinoma of unknown primary origin (CUP) pose a difficult diagnostic challenge, but a missed diagnosis of the primary tumor site is, unfortunately, a frequent occurrence. Musser and colleagues describe a patient with a large para-aortic mass that was initially diagnosed as CUP, but was subsequently identified as metastatic seminoma that showed remarkable spontaneous regression. Background. A 63-year-old man presented to an emergency department with abdominal and back pain. A 5 × 3 × 2 cm para-aortic mass was found adjacent to the left kidney, but the location of the primary tumor could not be identified. He was referred to a tertiary center with a diagnosis of retroperitoneal carcinoma of unknown primary origin. Atrophy of the left testicle was noted. Review of the biopsy material obtained at the first presentation showed histology characteristic of seminoma, and imaging revealed the presence of small intratesticular lesions. Repeat CT showed complete resolution of the metastatic para-aortic mass. The patient underwent left orchiectomy and adjuvant radiation therapy, and showed no signs of disease 6 months later. Investigations. CT of the chest, abdomen and pelvis, measurement of serum tumor markers, upper gastrointestinal endoscopy, colonoscopy, PET–CT and percutaneous needle biopsy of the para-aortic mass at the first presentation; physical examination, review of biopsy specimen with immunohistochemical staining for tumor markers, testicular ultrasonography and repeat CT of the chest, abdomen and pelvis at the second presentation. Diagnosis. Metastatic seminoma with spontaneous regression of the metastatic lesion. Management. Radical orchiectomy and adjuvant radiation therapy.

Retroperitoneal tumors are rare. Most of these tumors arise from mesothelial or connective tissues in the retroperitoneum. We report the first case, for us, of a cystic neuroendocrine retroperitoneal carcinoma in a 71-year-old woman. The discussion is focused on the radiographic findings, immunohistochemical studies and the controversial diagnosis.

Primary retroperitoneal carcinoma is a rare but highly aggressive tumour often resulting in infiltration of abdominal organs and diaphragm. We describe a case of retroperitoneal carcinoma infiltrating the diaphragm, the lower lobe of the left lung and ribs IX and X, but sparing the abdominal organs. After thoracoabdominal access, our patient underwent resection of the retroperitoneal carcinoma, left hemidiaphragm and ribs IX and X with wedge resection of the left lower lobe. Haematogenous lung metastasis from retroperitoneal carcinoma is well known; on the contrary, direct transdiaphragmatic lung invasion is very rare and requires thoracoabdominal access for a one step operation, representing one of the most stimulating challenges for thoracic surgeons.

To determine the incidence of abdominal-wall tumor implantation following laparoscopic procedures in patients with known malignancies, we reviewed 550 laparoscopic procedures performed on the Gynecologic Oncology Service between November 1990 and December 1993. In 100 procedures malignancy was documented cytologically or histologically, 84 with intraperitoneal and 16 with retroperitoneal disease. Ovarian cancer comprised 80% (67/84) of the procedures with intraperitoneal malignancy; the remainder consisted of fallopian tube (2), endometrial (11), cervical (1), breast (2), and gastric (1) carcinomas. Except for a recurrent squamous cell carcinoma of the cervix, all intraperitoneal carcinomas were adenocarcinomas. Four hundred twenty-three different abdominal-wall puncture sites were used, 37 Veress needle sites, and 386 laparoscopic ports. One of the 423 (0.2%) abdominal-wall puncture sites developed an implantation, for an incidence of 1.0% (1/100) per procedure. This developed after a second-look laparoscopic procedure for ovarian carcinoma in which only microscopic disease was present. If just intraperitoneal disease is considered, the incidence of implantation was 0.3% (1/351) per abdominal puncture and 1.2% (1/84) per procedure. No port site that was irrigated developed implantation. We concluded that abdominal-wall tumor implantation at the abdominal-wall puncture site is an infrequent occurrence after laparoscopy in patients with intraperitoneal and retroperitoneal carcinoma.

Determinations of the biochemical tumor markers, Α-fetoprotein (AFP) and Β-human chorionic gonadotropin (Β-HCG) gained much importance in respect to staging and follow-up examination of patients presenting with testicular cancer. After cytostatic chemotherapy the reliability of tumor markers is diminished. Retroperitoneal lymphadenectomy (RLA) was done in 60 patients after chemotherapy. Tumor marker elevation was found only in 52% of the patients showing retroperitoneal carcinoma (n = 25).

A statistically significant correlation was demonstrated between the content of PCB and DDE in lipids extracted from subcutaneous abdominal tissue of terminal patients and their age. A higher concentration of PCB and DDE was found in extracted lipids of adipose tissue samples from terminal cancer patients (malignant lymphoma, retroperitoneal carcinoma, glioblastoma, adenocarcinoma, cancer of the breast, mesothelioma, carcinoma of the cervix, pulmonary carcinoma, cancer of the rectum, cancer of the colon, lymphosarcoma, etc.) than in the adipose tissue of patients who died of other diseases. This difference was statistically significant. The results are discussed and the need for further investigations of a possible cause—effect relationship between exposure to organochlorine compounds and neoplasias is stressed.