Retroperitoneum
The space at the back of the abdomen, behind the gut's lining, holding the kidneys, adrenals, pancreas, aorta and the para-aortic lymph nodes. Tumours here grow large before they are felt.
Retroperitoneal sarcomas (liposarcoma, leiomyosarcoma) are removed en bloc with adjacent organs and were the subject of the STRASS trials of preoperative radiotherapy; kidney, adrenal and pancreatic cancers are retroperitoneal organs. Para-aortic and retroperitoneal lymph nodes are staging sites for testicular, cervical, endometrial and gastric cancers, and retroperitoneal lymph node dissection remains part of testicular cancer treatment. Retroperitoneal spread often presents as back pain or ureteric obstruction.
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