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JAMA Surgery Clinical Challenge |

A Man With a Giant Retroperitoneal Mass QUIZ

John Hardaway, MD, PhD1; Hiromichi Ito, MD1
[+] Author Affiliations
1Department of Surgery, College of Human Medicine, Michigan State University, East Lansing
JAMA Surg. 2016;151(8):775-776. doi:10.1001/jamasurg.2016.0268.
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A man aged 54 years presented to the emergency department with a 1-month history of generalized weakness and bilateral lower extremity swelling that had progressed to his upper abdomen. What is your diagnosis?

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Figure 1.

A, In addition to lower extremity edemas, the abdomen of the patient was markedly taut and distended. B, Representative computed tomography images with intravenous and oral contrast. Note the patient’s descending colon was severely displaced by the retroperitoneal mass and was located on the patient’s right side. The mass enveloped the left kidney without evidence of hydronephrosis.

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Figure 2.

Excised fatty tumor; it was 42.5 × 39.5 × 19.5 cm and 16.8 kg.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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