Recurrence of retroperitoneal fibrosis with pancreatic involvement - the importance of imaging methods

• Authors: Regina Djerassi , Martin Krupev , Milena Nikolova , Nikolai Naumov , Valeri Marianovski , Chavdar Elenkov , Arman Postadjian
• Languages of publication: EN

Abstracts

EN

Retroperitoneal fibrosis (RPF) is a rare disease associated with the development of chronic inflammation and fibrogenesis in the retroperitoneal space. The disease usually manifests with acute or acute over chronic renal failure and/or urosepsis. Pancreatic involvement in RPF is rare but has been described in the literature. The diagnosis of RPF is made mainly by imaging methods. Abdominal echography scan reveals the presence of an obstruction with or without inflammation; computed tomography and magnetic resonance imaging show the type and the spreading of fibrosis. Here, we report a 50-year-old female patient diagnosed with RPF during operative intervention in 2003. Initial treatment with corticosteroids and tamoxifen lead to remission. In 2007, late recurrence was observed, with tumor-like lesions over the upper, posterior, and anterior surfaces of the pancreas, spreading to intraperitoneal structures and more pronounced on the left side. Abdominal echography on day 30 showed that corticosteroid treatment lead to a decrease in the tumor-like lesions.

Keywords

EN

Retroperitoneal fibrosis; Pancreatic involvement; Diagnosis; Treatment; Corticosteroids; Azathioprine; Ureteral desobstruction

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2008
• Volume: 3
• Issue: 3
• Pages: 365-369

Dates

published

1 - 9 - 2008

online

10 - 7 - 2008

Contributors

author

Regina Djerassi

• Clinic of Nephrology, University Hospital Alexandrovska, Sofia, Bulgaria

author

Martin Krupev

• Department of Radiology, University Hospital Alexandrovska, Sofia, Bulgaria

author

Milena Nikolova

• Clinic of Nephrology, University Hospital Alexandrovska, Sofia, Bulgaria

author

Nikolai Naumov

• Emergency Hospital Pirogov, Sofia, Bulgaria

author

Valeri Marianovski

• Emergency Hospital Pirogov, Sofia, Bulgaria

author

Chavdar Elenkov

• Department of Urology, University Hospital Alexandrovska, Sofia, Bulgaria

author

Arman Postadjian

• Department of Cardiology, University Hospital St. Anna, Sofia, Bulgaria

References

• [1] Vivas I., Nicolás A.I., Velázquez P., Elduayen B., Fernández-Villa T., Martínez-Cuesta A., Retroperitoneal fibrosis: typical and atypical manifestations., Br. J. Radiol., 2000, 73, 214–222
• [2] Bonnet C., Arnaud M., Bertin P., Treves R., Gotteron RD., Idiopathic retroperitoneal fibrosis with systemic manifestations., J. Rheumatol., 1994, 21, 360–362
• [3] Dehner L.P., Coffin C.M., Lauren V., Idiopathic fibrosclerotic disorders and other inflammatory pseudotumors., Semin. Diagn. Pathol., 1998, 15, 161–173
• [4] Klisnick A., Fourcade J., Ruivard M., Baud O., Souweine B., Boyer L., et al., Combined idiopathic retroperitoneal and mediastinal fibrosis with pericardial involvement., Clin. Nephrol., 1999, 52, 51–55 [PubMed]
• [5] Kuramochi S., Kawai T., Yakumaru K., Mikata A., Torikata C., Kasuga Y., et al., Multiple pulmonary hyalinizing granulomas associated with systemic idiopathic fibrosis., Acta. Pathol. Jpn., 1991, 41, 375–382
• [6] Oguz K.K., Kiratli H., Oguz O., Cila A., Oto A., Gokoz A., Multifocal fibrosclerosis: a new case report and review of the literature., Eur. Radiol., 2002, 12, 1134–1138 http://dx.doi.org/10.1007/s00330-001-1158-4[Crossref]
• [7] Duvic C., Desrame J., Leveque C., Nedelec G., Retroperitoneal fibrosis, sclerosing pancreatitis and bronchiolitis obliterans with organizing pneumonia., Nephrol. Dial. Transplant., 2004, 19, 2397–2399 http://dx.doi.org/10.1093/ndt/gfh050[Crossref]
• [8] Cutaputti A., Burrell M.I., Boyer J.L., Pseudotumor of the pancreas associated with retroperitoneal fibrosis: a dramatic response to corticosteroid treatment., Am. J. Gastroenterol., 1995, 90, 1155–1158
• [9] Voss S.D., Kruskal J.B., Kane R.A., Chronic inflammatory pseudotumor arising in the hepatobiliary-pancreatic system: progressive multisystemic organ involvement in four patients., M. J. Roentgenol., 1999, 173, 1049–1054 [PubMed]
• [10] Miyajima N., Koike H., Kawaguchi M., Zen Y., Takahashi K., Hara N., Idiopathic retroperitoneal fibrosis associated with IgG4-positive-plasmacyte infiltrations and idiopathic chronic pancreatitis., Int. J. Urol., 2006, 13, 1442–1444 http://dx.doi.org/10.1111/j.1442-2042.2006.01568.x[Crossref]
• [11] Wu J., Catalano E., Coppola D., Retroperitoneal fibrosis (Ormond’s disease): clinical pathologic study of eight cases., Cancer. Control., 2002, 9, 432–437 [PubMed]
• [12] Demko T.M., Diamond J.R., Groff J., Obstructive nephropathy as a result of retroperitoneal fibrosis: a review of its pathogenesis and associations., J. Am. Soc. Nephrol., 1997, 8, 684–688
• [13] Bowie J.D., Bernstein J.R., Retroperitoneal fibrosis: ultrasound findings and case report., Clin. Ultrasound., 1976, 4, 435–437 http://dx.doi.org/10.1002/jcu.1870040613[Crossref]

Identifiers

DOI

10.2478/s11536-008-0017-y