Imaging signs of retroperitoneal rupture:
(1) acute hemorrhage within the tumor
(2) acute retroperitoneal effusion
(3) acute hemorrhage in the subcapsular space
(4) acute hemorrhage in the perirenal space
(5) retroperitoneal tumor nodules distinct from the primary tumor
Imaging signs of intraperitoneal rupture:
(1) acute intraperitoneal hemorrhage
(2) intraperitoneal tumor nodules
(3) mesenteric infiltration
(4) tumor fracture communicating with an intraperitoneal effusion
where:
• Acute hemorrhage on an unenhanced CT scan is hyperdense.
• A nonhemorrhagic peritoneal effusion was not used as a criterion for tumor rupture (page 204).
The authors recommended not upstaging a small, localized retroperitoneal-only rupture.
