Retroperitoneal Masses Decoded: A Practical Multidisciplinary Diagnostic and Surgical Strategy Integrating Radiology and Pathology

Retroperitoneal masses comprise a heterogeneous group of benign and malignant entities originating from mesenchymal, lymphoid, neurogenic, germ cell, and metastatic tissues. Because of the large potential space of the retroperitoneum, tumors frequently attain significant size before detection and therefore present diagnostic and therapeutic challenges. Management varies widely depending on tumor biology; consequently, inappropriate surgical intervention may lead to major morbidity without therapeutic benefit. This narrative review provides a clinically oriented diagnostic and management framework integrating radiologic assessment, biopsy strategy, operative planning, and pathological interpretation. Retroperitoneal sarcomas require complete macroscopic resection, whereas lymphoma and germ cell tumors are primarily treated medically. Multidisciplinary coordination between surgeons, radiologists, and pathologists is therefore essential to avoid mismanagement and improve patient outcomes.