RT Journal
A1 Stanwix MG, Edil BH
T1 IMage of the month—quiz case
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD May 1
VO 145
IS 5
SP 499
OP 499
DO 10.1001/archsurg.2010.60-a
UL http://dx.doi.org/10.1001/archsurg.2010.60-a
AB 
A healthy 53-year-old woman with chronic lower back pain and radicular pain from a known herniated disk underwent routine imaging by her primary care physician. Magnetic resonance imaging demonstrated a new retroperitoneal 2.1 × 3.0–cm mass at the crus of the diaphragm not identified in an identical study 1 year prior. Further investigation into her history disclosed some flushing and hot flashes. However, she experienced no urinary symptoms (dysuria and hematuria), fevers, abdominal pain, nausea, vomiting, changes in bowel patterns, weight fluctuation, or heart palpitations. Physical examination revealed a normotensive, mildly overweight woman with no pain or masses appreciated on abdominal palpation. No neurological deficit was noted in the thoracic distribution, but bilateral lower lumbar radicular pain to the mid-thigh was reproduced with supine straight leg raising. Results of urinary tests, hormonal workup for a functional retroperitoneal tumor, and standard blood tests were unremarkable.