International Journal of Clinical & Medical Images

We report the case of a male patient, 55 years, with a chronic smoking past for over 20 years. He has been receiving treatment for chronic lower back pain and abdominal pain for since 5 months. Within this period, he has lost weight of about 5 kg, and has noticed swelling at the right lumbar region which has been increasing gradually. An abdominal Ultrasound showed a large heterogeneous tissue mass poorly limited with internal microcalcifications measuring more than 10 cm, located in the right retroperitoneal space evoking firstly a tumoral origin. A Computer Tomography (CT) Scan showed a right retroperitoneal tumor process evoking firstly a lymphoma.

Biopsy for histological assessment was made reporting a moderately to well-differentiated squamous cell carcinoma. The immunohistochemical complement concluded to carcinoma of urothelial origin, gata3+. CT Staging scan (Thoraco-abdomino-pelvic extension) have been realized, showing the retroperitoneal mass 96 × 70  × 105 mm infiltrating the kidney, the lower right edge of the liver and the posterior thoracic wall. No other anomaly was found elsewhere. The established diagnosis was a metastasis of an urothelial carcinoma and the patient will receive Gemcitabine-cisplatin protocol in a palliative strategy (Figures 1 and 2).