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Solid tumors of the peritoneum, omentum, and mesentery in children: radiologic-pathologic correlation: from the
Ellen M Chung1, David M Biko, Aaron M Arzamendi
1From the Department of Radiology and Radiological Sciences (E.M.C.) and Department of Pathology (J.T.S.), F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Department of Radiology, Pediatric Radiology Section, American Institute for Radiologic Pathology, Silver Spring, Md (E.M.C.); Department of Radiology, David Grant USAF Medical Center, Travis AFB, Calif (D.M.B.); and F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (A.M.A., J.T.M.).
Insights
Pediatric intraperitoneal solid tumors differ from adult types. Radiologists must recognize diverse causes, from localized masses like inflammatory myofibroblastic tumor to diffuse diseases such as desmoplastic small round cell tumor, for accurate diagnosis and management.
Area of Science:
- Pediatric Radiology
- Abdominal Imaging
- Oncology
Background:
- Intraperitoneal solid tumors are rare in children, presenting a distinct histologic spectrum compared to adults.
- Understanding these pediatric neoplasms is crucial for accurate diagnosis and effective management.
Purpose of the Study:
- To outline the differential diagnosis of pediatric intraperitoneal solid tumors.
- To highlight key imaging features distinguishing various neoplastic and non-neoplastic masses.
Main Methods:
- Review of pediatric intraperitoneal masses.
- Description of imaging characteristics for specific tumor types.
- Correlation of imaging findings with histologic diagnoses.
Main Results:
- Localized masses include inflammatory myofibroblastic tumor, Castleman disease, and mesenteric fibromatosis.
- Diffuse peritoneal disease can be caused by desmoplastic small round cell tumor (DSRCT), lymphoma, or rhabdomyosarcoma.
- Specific imaging features aid in differentiating these conditions.
Conclusions:
- Radiologists can provide an appropriate differential diagnosis for pediatric intraperitoneal masses.
- Knowledge of this spectrum aids in guiding patient management and treatment strategies.
Abstract:
Intraperitoneal solid tumors are far less common in children than in adults, and the histologic spectrum of neoplasms of the peritoneum and its specialized folds in young patients differs from that in older patients. Localized masses may be caused by inflammatory myofibroblastic tumor, Castleman disease, mesenteric fibromatosis, or other mesenchymal masses. Inflammatory myofibroblastic tumor is a mesenchymal tumor of borderline biologic potential that appears as a solitary circumscribed mass, possibly with central calcification. Castleman disease is an idiopathic lymphoproliferative disorder that appears as a circumscribed, intensely enhancing mass in the mesentery. Mesenteric fibromatosis, or intra-abdominal desmoid tumor, is a benign tumor of mesenchymal origin associated with familial adenomatous polyposis. Mesenteric fibromatosis appears as a mildly enhancing, circumscribed solitary mass without metastases. Diffuse peritoneal disease may be due to desmoplastic small round cell tumor (DSRCT), non-Hodgkin lymphoma, or rhabdomyosarcoma. DSRCT is a rare member of the small round blue cell tumor family that causes diffuse peritoneal masses without a visible primary tumor. A dominant mass is typically found in the retrovesical space. Burkitt lymphoma is a pediatric tumor that manifests with extensive disease because of its short doubling time. The bowel and adjacent mesentery are commonly involved. Rhabdomyosarcoma may arise as a primary tumor of the omentum or may spread from a primary tumor in the bladder, prostate, or scrotum. Knowledge of this spectrum of disease allows the radiologist to provide an appropriate differential diagnosis and suggest proper patient management.
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