The Role of Multidetector CT in the Diagnosis of Retroperitoneal Fibrosis: Report of a Case

Differential Diagnosis: Retroperitoneal Fibrosis and Oncological Diseases

Retroperitoneal fibrosis is a connective disease of the auto-inflammatory/auto-immune type of the retroperitoneum with unknown etiology and pathological mechanism. The manifestations of the pathology can be local or systemic. Amongst the local symptoms, the dull and constant pain in the hips, back or abdomen is the most frequent.

We report here a case of a 47-year-old woman, whose pathogenic mechanism could be related to an “IgG4-related disease” disorder as suggested by an increased serum level of this subclass of IgG and the positive immunohistochemistry.

The diagnosis is not easy, because this pathology generates masses; adenomegalies with retro peritoneal development, that makes it similar to lymphomas or metastases from ovarian tumors.

Ultrasonography for Preoperative Diagnosis of Retroperitoneal Fibrosis

This study aimed to assess the application of ultrasonography for preoperative diagnosis of retroperitoneal fibrosis (RPF). A total of 51 patients with clinically suspected RPF underwent transabdominal ultrasonography and ultrasound-guided histopathologic biopsy (tAU-UGHB). Retroperitoneal fibrosis was diagnosed in 35 patients; of these, 31 cases (88.6%) received a diagnosis using tAU-UGHB. The ultrasonographic images mainly showed solid, irregular isoechoic masses, which were present behind the retroperitoneum and surrounded the abdominal aorta, inferior vena cava, and ureters and had clear borders with the encapsulated structures. Compared with other retroperitoneal lesions, RPF lesions were mainly located below the initial level of the renal artery, and their internal flow signals were not rich (P < 0.05). Retroperitoneal fibrosis had characteristic ultrasonographic features, and color Doppler ultrasound-guided biopsy could be positioned accurately, safely, and efficiently; therefore, tAU-UGHB can be used as an effective modality for preoperative diagnosis of RPF.

Retroperitoneal Fibrosis Due to Opium Abuse: A Case Series and Literature Review

Retroperitoneal fibrosis (RPF) is a rare condition with an unclear etiology, presenting with the development of aberrant chronic nonspecific fibroinflammatory tissue in the retroperitoneal space, which can result in entrapment and obstruction of the retroperitoneal structures. RPF is a subtype of chronic periaortitis, and can be divided into two types: primary (or idiopathic) and secondary. RPF is usually idiopathic, but can also be secondary to malignancies, certain drugs, infections, surgery, and trauma. The systemic clinical manifestations are nonspecific and include low-grade fever, fatigue, anorexia, weight loss, and myalgia. We report five patients admitted to our hospital with clinical, laboratory, imaging, and pathologic findings compatible with RPF, and we describe their treatment and follow-up. We were suspicious that the impurities of some types of opium have an important role in the pathogenesis of RPF. Some of our patients used opium again after the follow-up period; however, they used a different type with a different origin, and we were surprised to see that RPF did not form again.

Diagnosis and treatment of retroperitoneal fibrosis: A case report

Retroperitoneal fibrosis (RPF) is a rare disease of unclear etiology, which is characterized by a chronic non-specific inflammation of the retroperitoneum. The present study reports the case of a 36-year-old male with a 3-month history of lower right abdominal pain (intermittent) and weight loss (5 kg). A mass was identified that covered the surface of the abdominal aorta and the inferior vena cava near the right renal hilum. Three shots with an automated gun were employed to biopsy the mass. The patient began taking prednisone one month subsequent to the surgery at a dose of 10 mg, three times a day once a month and at continuously reducing doses for 1 year. CT scans showed that the retroperitoneal mass decreased in size with the progression of the treatment and that the mass had almost disappeared on the final month’s MRI scan. In conclusion, the diagnosis of retroperitoneal fibrosis is an effective process that excludes the other diagnoses for the lesion. A biopsy of the mass is a necessity for the final stage of diagnosis and is supported by the response to the steroid treatment.