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Case Report Open Access

Primary retroperitoneal squamous cell carcinoma: A case report

  • Authors:
    • Fang Zhang
    • Yuan Gui
    • Jing Zhang
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, Guangdong 519100, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 574
    |
    Published online on: October 6, 2025
       https://doi.org/10.3892/ol.2025.15320
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Abstract

Retroperitoneal squamous cell carcinoma (SCC) is an extremely rare tumor originating from the retroperitoneum, with an unclear etiology and origin. Imaging studies are the preferred diagnostic modality for retroperitoneal tumors. The present study reports a case of retroperitoneal SCC and assesses its imaging characteristics. A 49‑year‑old female patient presented to the outpatient department of The Fifth Affiliated Hospital of Zunyi Medical University with a palpable abdominal mass detected 2 years ago. Ultrasound examination revealed two abnormal solid masses in the left adnexal region, suggesting a pelvic mass of undetermined origin. The patient was admitted to the hospital for further evaluation and treatment. Abdominal computed tomography (CT) and pelvic magnetic resonance imaging (MRI) revealed a retroperitoneal mass in the left pelvis. The patient subsequently underwent resection of the lesion and regional lymphadenectomy. Postoperative pathology confirmed poorly differentiated retroperitoneal SCC. After discharge, the patient received 6 months adjuvant chemotherapy and remained recurrence‑free during the follow‑up. Due to its deep location, proximity to several organs and non‑specific clinical manifestations, retroperitoneal SCC is difficult to differentiate from other retroperitoneal tumors preoperatively using CT or MRI. Moreover, its treatment differs from that of common retroperitoneal tumors, such as leiomyosarcoma. Thus, summarizing the imaging features of retroperitoneal SCC is essential for guiding treatment selection and improving patient outcomes.
View Figures

Figure 1

CT images. (A) Non-contrast enhanced
image reveals an irregularly shaped, heterogeneous density soft
tissue mass in the left pelvic cavity. (B) Non-contrast lymph node
image shows enlarged lymph nodes in the retroperitoneal space. (C)
Enhanced lymph node image demonstrates heterogeneous enhancement of
the enlarged lymph nodes. (D) Arterial phase enhanced scan shows
heterogeneous mild enhancement of the mass. (E) Venous phase image
reveals an increase in the enhancement of the mass. (F) Delayed
phase scan shows persistent heterogeneous delayed enhancement of
the mass. (G) Immediate postoperative CT image shows that the
original left pelvic mass has been resected, with a small amount of
gas and exudate visible in the surgical area. (H) Follow-up CT 1
month after surgery shows that the exudate in the surgical area has
been mostly absorbed, and the anatomical structures are becoming
clearer. (I) Follow-up CT 2 months after surgery shows good
recovery of the surgical area, with no clear signs of recurrence.
Solid arrows indicate the tumor area; dashed arrows indicate
enlarged lymph nodes; circles outline the postoperative tumor area,
with no obvious signs of recurrence CT, computed tomography.

Figure 2

Magnetic resonance imaging features of
the lesion. (A) Axial T1-weighted imaging (T1WI) demonstrates
heterogeneous signal intensity, with small patchy hyperintense foci
observed within the lesion, suggesting possible intratumoral
hemorrhage. (B) Axial T2-weighted imaging with fat-suppression
shows heterogeneous signal intensity, with small patchy
hyperintense areas noted, indicating possible cystic degeneration
or necrosis within the tumor. (C) Diffusion-weighted imaging (DWI)
reveals hyperintense signal within the lesion. (D) The apparent
diffusion coefficient (ADC) map shows corresponding hypointensity.
(E) Axial T1-weighted imaging with fat-suppression displays
heterogeneous signal intensity, with small patchy hyperintense foci
visible within the tumor. (F) In the arterial phase, the tumor
exhibits marked but heterogeneous enhancement. (G) In the venous
phase, the tumor continues to show marked heterogeneous
enhancement, which is more pronounced compared to the arterial
phase. (H) In the delayed phase, the tumor demonstrates persistent
heterogeneous enhancement, with small patchy hypointense areas
indicating non-enhancing regions. (I) Coronal T2-weighted imaging
with fat suppression reveals regional lymph nodes, which show
heterogeneous enhancement on contrast-enhanced imaging. The
adjacent bladder and uterus are compressed and displaced to the
right. Solid arrows indicate the tumor area; dashed arrows indicate
enlarged lymph nodes. DWI, diffusion-weighted imaging; ADC,
apparent diffusion coefficient.

Figure 3

Histopathological and
immunohistochemical images of poorly differentiated squamous cell
carcinoma. (A) Gross appearance of the tumor. (B) Tumor cells are
arranged in nests in some areas and in diffuse solid sheets in
others, without evident keratin pearls. There is marked variation
in cell size and shape, with an increased nuclear-to-cytoplasmic
ratio, deep nuclear staining, coarse chromatin, and frequent
mitotic figures, which are indicative of poorly differentiated
squamous cell carcinoma. (H&E). Magnification, ×40. (C) The
tissue sample shows Pan-cytokeratin positivity. (D) Immunostaining
for CK5/6 is positive in the displayed section. Magnification, ×40.
(E) Nuclear expression of p40 is observed in the tumor cells. (F)
The Ki-67 proliferation index is approximately 70%.
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Copy and paste a formatted citation
Spandidos Publications style
Zhang F, Gui Y and Zhang J: Primary retroperitoneal squamous cell carcinoma: A case report. Oncol Lett 30: 574, 2025.
APA
Zhang, F., Gui, Y., & Zhang, J. (2025). Primary retroperitoneal squamous cell carcinoma: A case report. Oncology Letters, 30, 574. https://doi.org/10.3892/ol.2025.15320
MLA
Zhang, F., Gui, Y., Zhang, J."Primary retroperitoneal squamous cell carcinoma: A case report". Oncology Letters 30.6 (2025): 574.
Chicago
Zhang, F., Gui, Y., Zhang, J."Primary retroperitoneal squamous cell carcinoma: A case report". Oncology Letters 30, no. 6 (2025): 574. https://doi.org/10.3892/ol.2025.15320
Copy and paste a formatted citation
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Spandidos Publications style
Zhang F, Gui Y and Zhang J: Primary retroperitoneal squamous cell carcinoma: A case report. Oncol Lett 30: 574, 2025.
APA
Zhang, F., Gui, Y., & Zhang, J. (2025). Primary retroperitoneal squamous cell carcinoma: A case report. Oncology Letters, 30, 574. https://doi.org/10.3892/ol.2025.15320
MLA
Zhang, F., Gui, Y., Zhang, J."Primary retroperitoneal squamous cell carcinoma: A case report". Oncology Letters 30.6 (2025): 574.
Chicago
Zhang, F., Gui, Y., Zhang, J."Primary retroperitoneal squamous cell carcinoma: A case report". Oncology Letters 30, no. 6 (2025): 574. https://doi.org/10.3892/ol.2025.15320
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