Alina T
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60 Y.O. WOMAN PRESENTS W/ RECENT LOWER BACK PAIN (1 MTH DURATION).
Hx: HODGKIN - 20 YRS AGO, TREATED W/ ABDOMINAL IRRADIATION + CHEMOTHERAPY . (NO SIGNS OF RECURRENCE ON FOLLOW-UP)
U REQUEST MRI: 10/15 CM MASS OF LEFT RETROPERITONEUM.
WHAT'S YOUR FIRST GUESS ON THIS CONDITION, CONSIDERING Hx?
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| mani
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were there some options given with the question?
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| mash
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non hodgkins lymphoma
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| mdwannabe
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splenic mass...recurrence.
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| amitjosh
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Is it soft tissue angiosarcoma secondary to irradiation?
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| Malaysian
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It can be recurrence of lymphoma or retroperitoneal firbrosis???
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| dariush
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DD:
1-Recurrence
2-the begining of IRF
3-a new tumor (ovarian cyst/tumor, transitional cell carcinoma,etc.)
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| Alina T
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sorry guys!...vast diff diagnosis. I should have given the options in the first place.
A. DESMOID TUMOR
B. RECURRENT HODGKIN DIS
C. RHABDOMYOSARCOMA
D. LEIOMYOSARCOMA
E. MFH (MALIGNANT FIBROUS HISTIOCYTOMA)
good discussion though! 
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There are 3 types of people: those who make things happen, those who watch things happen, and those who wonder what happened.
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| mash
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MALIGNANT FIBROUS HISTIOCYTOMA
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| dariush
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D. totally new, the most common benign tumor in female; might even be collagenous or calcified (usu. Multiple though)
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| mani
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i would go for E,
dariush, D is liomyosarcoma, not liomyoma. i think itss typo
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| Alina T
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yes, it is MFH. It is the most common postirradiation sarcoma !
Leiomyosarcomas occur usually in the uterus or GIT.
choice B is wrong once they state in the stem that there wasnt evidence of that on regular follow-up.
all the best!
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| dariush
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oops thanx mani, i was too sleepy last night
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