A case of idiopathic retroperitoneal fibrosis presenting as gallbladder carcinoma

Abstract

Background Retroperitoneal fibrosis (RPF) is a rare disease with a poor prognosis characterized by systemic inflammation and fibroinflammatory tissue. Idiopathic RPF (IRPF) accounts for approximately two-thirds of RPF cases. Case presentation A 56-year-old female patient with abdominal distension was admitted to Changxing Hospital. Laboratory tests revealed mild anemia and elevated CA125, while IgG4 and autoantibodies were within the normal ranges. Computed tomography (CT) revealed a gallbladder-occupying lesion, pancreatic cyst and retroperitoneal mass, which may have contributed to bilateral ureteral compression and hydronephrosis. The initial diagnosis was gallbladder carcinoma with lymph node metastasis. Then, abdominal adhesiolysis, cholecystectomy and partial hepatectomy were performed. Histologically, there were fibrosis and inflammation in the retroperitoneal tissue without any malignant cells in the retroperitoneal or gallbladder tissue. Finally, we confirmed the diagnosis of idiopathic retroperitoneal fibrosis, chronic cholecystitis and pancreatic cyst. The patient recovered well following the CT scan, in which dilatation of the bile duct was reduced, and effusion of the bilateral upper ureter was no longer significant. Conclusion This atypical case illustrates that RPF can be combined with other biliary tract diseases. The coexistence of other diseases conceals the symptoms of RPF, which increases the difficulty of image identification. A high degree of suspicion is necessary for routine clinical work. As more cases are reported, further advances in the diagnosis and treatment of RPF can be expected.

Clinical presentation and organ-based outcomes of Multifocal fibrosclerosis: A systematic review

“…The full texts of 530 articles were read, and 116 articles were shortlisted for the final extraction, 112 of which were case reports and 4 were case series. 3,18...…”

Intelligent Ureteral Stent for Early Detection of Hydronephrosis

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The ureteral stent is a commonly used commercial device that is placed in the ureter to bridge flow of urine from the kidney to the bladder. This type of stent is typically made of a slender polymeric tube with an approximate length of 20-30 cm and is used to drain ureteral obstructions resulting from different causes, including kidney stones, [6,7] pelvic malignancies, [8] retroperitoneal adenopathy and fibrosis, [9,10] direct tumor invasion, [11] and congenital defects in the ureteral wall. [12] These stents have also found critical use in renal transplantation, [13] anatomical stenosis, [14] and post-surgical complications such as stone fragment passage after extracorporeal shock wave lithotripsy.

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