Benign Retroperitoneal Fibrosis and Renal Cell Carcinoma

Abstract

We report benign retroperitoneal fibrosis associated with renal cell carcinoma in a 56-year-old woman. Based on the preoperative evaluation and initial surgical exploration, the retroperitoneal mass was assumed to be metastatic renal cell carcinoma and chemotherapy rather than surgical resection was offered to the patient. A second opinion was sought and repeat exploration revealed a resectable cell carcinoma and retroperitoneal tissue that was pathologically benign idiopathic retroperitoneal fibrosis. This report emphasizes that a patient with an otherwise resectable primary tumor must undergo multiple, deep biopsies of retroperitoneal masses before making a presumptive diagnosis of malignant retroperitoneal fibrosis secondary to metastatic cancer.

Renal cell carcinoma clinically involving adjacent organs

“…Theoretically, because of the central retroperitoneal location and the natural protective barrier of Gerota fascia, it is considerably more frequent for a renal mass to indent adjacent organs rather than to directly infiltrate them 17. Furthermore, large renal masses frequently induce a significant amount of reactive desmoplasia, obliterating surgical tissue planes, and mimicking pT4 disease 18. Our study confirmed that a majority (60%) of patients, thought to have invasion of adjacent organs clinically, were downstaged during final pathologic evaluation.…”

Fine Needle Aspiration Biopsy of Idiopathic Retroperitoneal Fibrosis

“…These findings are nonspecific but help to exclude other diagnoses, particularly malignancy, which is often suspected in patients who have IRF. 2 It is important to stress, however, that a false negative result may occur with a malignancy that is associated with extensive desmoplastic fibrosis, as seen, for example, with some cases of metastatic gastric carcinomas of the signet-ring cell type. Given the prominence of lymphoid cells, the differential diagnosis includes low grade lymphoma.…”

Fibrosis retroperitoneal asociada a neoplasias malignas: Serie de casos clínicos

“…Fibrosis retroperitoneal y cáncer -J. Vega et al tumores carcinoides, linfomas, mieloma múltiple y sarcomas 7,9,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . Las asociaciones con tumores benignos son menos frecuentes (angiomiolipomas renales, ganglioneuromas, tumores del aparato yuxtaglomerular) [30][31][32] .…”

“…Se ha planteado que la fibrosis puede ser secundaria a una reacción dermoplástica a la presencia de cé-lulas tumorales en el retroperitoneo, producto de citoquinas liberadas por el cáncer o una inflamación reactiva a la presencia del tumor 7,9,16,17,20,33,34 . En los tumores carcinoides se ha relacionado con altas concentraciones sanguíneas de serotonina y neuropéptidos 9,35 .…”