CT of recurrent retroperitoneal sarcomas

OBJECTIVE. We reviewed the medical records and CT scans of 33 patients with recurrent retroperitoneal sarcomas to determine the patterns of recurrent disease. MATERIALS AND METHODS. We reviewed the medical records and CT examinations obtained at the time the recurrence was diagnosed and tabulated data for al l patients, Data for patients with high-grade malignancies were compared wi th those of patients with low-grade malignancies to determine whether there were differences in the interval between initial tumor resection and recur rence. We also compared CT appearances to determine pat terns of recurrent disease. RESULTS. Twenty-five of 33 recurrences were detected within 2 years of init ial surgery. Only 16 patients had symptoms, and when present, most symptoms were nonspecific. In 28 (85%) patients, recurrent tumor was in the abdomen at the time of diagnosis. In nine patients, the largest detectable abdomin al tumor was less than 5 cm in diameter. Interval to recurrence was similar for patients with low- and high-grade tumors. Although the CT appearance w as similar for both grades, distant metastases were identified only in pati ents with high-grade malignancies. CONCLUSION. Primary retroperitoneal malignancies frequently recur within 2 years of initial surgical resection. For asymptomatic patients, diagnosis i s typically made during routine follow-up CT. Most patients have abdominal recurrences that may be small when first detected.