Primary retroperitoneal tumors

　　Retroperitoneal tumors mainly originate from the fat, loose connective tissue, fascia, muscle, blood vessels, nervous tissue, lymphatic tissue, and embryonic remnants in the retroperitoneal space, of which 2/3 are malignant tumors. Benign tumors include lipomas, fibromas, neuroganglionic tumors, cystic teratomas, and chemoreceptor tumors, while malignant tumors include lymphosarcomas, liposarcomas, fibrosarcomas, malignant schwannomas, and malignant teratomas.

　　Primary retroperitoneal tumors are of various types, and the most common tumors usually originate from the kidneys, adrenal glands, and various soft tissues behind the peritoneum. According to pathological and histological classification, primary retroperitoneal tumors mainly include soft tissue tumors, germ cell tumors, lymphohematopoietic system tumors, kidney tumors, adrenal gland tumors, metastatic tumors, and other rare tumors. According to biological behavior, they are divided into benign and malignant categories, and according to their origin, they have mesodermal, nervous tissue, urogenital system, and embryonic remnants, and so on.

　　Malignant tumors are more common than benign tumors, accounting for about 80%. Among them, malignant lymphoma is the most common, followed by fibrosarcoma, liposarcoma, undifferentiated sarcoma, smooth muscle sarcoma, and rhabdomyosarcoma. Neurogenic sarcoma is also common. Common benign tumors include lipomas, lymphomas or chylous cysts, renal cysts, dermoid cysts, and intestinal cysts.

　　Retroperitoneal tumors are generally located deep and fixed, with benign tumors being smaller in size and slower in growth; malignant tumors are larger in size and faster in growth. The diseases that primary retroperitoneal tumors can cause mainly include anemia, hypokalemia, acute peritonitis, and hypovolemic shock, as follows:

　　1, Anemia

　　Tumor bleeding or rapid growth of retroperitoneal tumors in children can lead to anemia.

　　2, Hypokalemia

　　When the tumor is large and pushes or compresses the gastrointestinal tract, the patient may suffer from anorexia, nausea and vomiting, diarrhea, etc., leading to a large loss of potassium and insufficient supplementation, causing a decrease in blood potassium levels and紊乱 of serum electrolytes.

　　3, Acute peritonitis

　　When the tumor ruptures, the stimulation of blood to the peritoneum can cause symptoms and signs of acute peritonitis such as abdominal pain, abdominal muscle tension, tenderness, and rebound pain.

　　4, Hypovolemic shock

　　When the tumor ruptures or invades large blood vessels, it can cause massive bleeding and hypovolemic shock.

　　Since the organs related to retroperitoneal tumors are all buried in the wide and loose connective tissue spaces behind the peritoneum, the tumor can grow secretly in this cavity before the onset of clinical symptoms and signs, and it can grow around and is not easily blocked. Therefore, early symptoms are often absent, and symptoms may not appear until the tumor grows to a relatively large size, but they are not severe. The symptoms and signs manifested are often related to the displacement and obstruction of the related organs (due to tumor compression). Due to the different tissue origin and location of retroperitoneal tumors, their clinical manifestations are also diverse, but there are also some common symptoms and signs. The clinical manifestations of primary retroperitoneal tumors mainly include the following aspects:

　　1. Abdominal mass

　　In the early stages, there are often no symptoms, and they are discovered during physical examination or by chance. Most patients first have abdominal discomfort, and in the late stage, there is significant abdominal pain, with a few patients experiencing back pain or inguinal area pain. As the tumor gradually increases in size, corresponding symptoms may appear, such as a feeling of fullness in the upper abdomen, which can even affect breathing; in the lower abdomen, there is a sense of坠胀.

　　2. Compression symptoms

　　Stimulatory symptoms caused by organ compression, such as nausea and vomiting; increased frequency of defecation or chronic intestinal obstruction, with symptoms of frequent urination, urgency, renal pelvis hydrops, which can cause lumbar and back pain, perineal and lower limb pain; compression of veins and lymphatic vessels can cause lower limb edema.

　　3. General symptoms

　　At a certain stage of development, symptoms such as weight loss, fever, fatigue, loss of appetite, and even cachexia may occur. In the case of pheochromocytoma, due to the secretion of adrenaline and norepinephrine, paroxysmal hypertension may occur; if the tumor compresses the pancreas, it can stimulate insulin secretion and lead to hypoglycemia, etc.

　　Primary retroperitoneal tumors are primary tumors with no effective preventive measures. In China, gastric cancer is relatively common, followed by liver cancer and colorectal cancer. In recent years, pancreatic cancer has been gradually increasing, with the most common being gastric, colorectal, and liver tumors. Since this disease is a primary tumor with an unknown etiology, prevention mainly focuses on regular physical examinations, reasonable diet, increased physical activity, and enhancing immunity. Early detection, early diagnosis, and early treatment can improve the prognosis of patients and prolong life.

　　The clinical examination methods for primary retroperitoneal tumors mainly include the following aspects:

　　1. X-ray abdominal films, gastrointestinal barium meal examination, and renal pelvis造影

　　X-ray abdominal films, gastrointestinal barium meal examination, and renal pelvis造影 are very helpful in understanding the relationship between the tumor and the abdominal cavity and retroperitoneal organs, and in making a definitive diagnosis. The abdominal film requires a frontal and lateral or oblique view. Selective aortography or vascular digital subtraction angiography is of great significance in determining the location, size, blood supply, and the judgment of benign or malignant nature of the tumor, as well as guiding treatment.

　　2. CT or MRI scans

　　CT or MRI scans are helpful for the localization and characterization of tumors. Ultrasound examination is more sensitive in distinguishing between cystic and solid tumors.

　　3. Puncture biopsy

　　Although the location of primary retroperitoneal tumors is sometimes clear, distinguishing between benign and malignant is difficult. If conditions permit, puncture biopsy can be performed, as well as using a miniature laparoscope (external diameter

　　Patients with primary retroperitoneal tumors should consume easily digestible, anticancer, immune-enhancing, and nutritionally rich and comprehensive foods, and avoid greasy, high-fat, cold and raw foods, as follows:

　　Firstly, eat more nutritious foods: sea cucumber, oysters, sea horses, crabs, white snakes, toads, horseshoe crabs, kiwi fruit, figs, walnuts, hawthorn, papaya, black plums, sugarcane, almonds, lotus seeds, silver ear, melon, gourds, mushrooms, mushrooms, adzuki beans.

　　1. Eat more foods that can shrink tumors: jellyfish, oysters, sea horses, crabs, white snakes, toads, horseshoe crabs, kiwi fruit, figs, walnuts, hawthorn, papaya, black plums, sugarcane, almonds, lotus seeds, silver ear, melon, gourds, mushrooms, mushrooms, adzuki beans.

　　2. For abdominal pain, eat horseshoe crabs, sharks, celery, pumpkin, chives, hawthorn, orange candy, soy sauce, loofah.

　　3. For edema and decreased urine, eat scallions, chrysanthemum buds, snails, earthworms, almonds, crabs, kelp, clams, wakame, sturgeon, red beans, crucian carp, lettuce, coconut milk, and snakehead fish.

　　4. For irregular bowel movements, eat figs, wheat bran, hawthorn, shark, mackerel, rabbit meat.

　　Secondly, avoid eating certain foods

　　1. Avoid smoking, alcohol, and spicy刺激性 foods.

　　2. Avoid moldy, contaminated, hard, rough, fibrous, greasy, sticky, and indigestible foods.

　　3. Avoid fried, smoked, pickled, raw and mixed foods.

　　4. Avoid gas-forming foods such as soybeans, green peas, and sweet potatoes.

　　Avoid overeating and force-feeding.

　　The main Western medical treatment methods for primary retroperitoneal tumors are surgical treatment, chemotherapy, and radiotherapy, as follows:

　　1. Surgical treatment

　　Surgical resection is the main treatment method for most retroperitoneal tumors. Many retroperitoneal tumors can be completely resected to achieve the goal of cure. Whether some retroperitoneal tumors can be resected needs to be determined after intraoperative exploration.

　　2. Chemotherapy

　　Primary retroperitoneal malignant lymphoma is very sensitive to chemotherapy. Once diagnosed, chemotherapy should be the first choice, and a high complete remission rate can be achieved.

　　3. Radiotherapy

　　Radiotherapy has a certain therapeutic effect on primary undifferentiated tumors and malignant lymphoma.

　　In summary, due to the late onset of symptoms of primary retroperitoneal tumors, it is not easy to make an early diagnosis. By the time of diagnosis, the symptoms are already quite advanced, so surgery is very difficult and the mortality rate is high. Lymphoma can be treated with radiotherapy or chemotherapy, with good recent efficacy. Neuroblastoma in children can also be treated with radiotherapy. Most retroperitoneal tumors other than lymphoma have a poor response to radiotherapy, but radiotherapy can still have a certain effect on symptom relief, tumor shrinkage, and prolonging life, so it is generally recommended that radiotherapy can be performed for those who cannot undergo surgery. The rapidly developing immunotherapy recently has not been very effective when used alone. Surgical resection is the main method of treating retroperitoneal tumors.